Please complete this questionnaire before your initial appointment so we can learn more about your student!
Click the button below to start.
Question 1 of 8
Student Name:
Question 2 of 8
Diagnosis, if applicable:
Question 3 of 8
What are the things that make your child awesome?
Question 4 of 8
What are some things that are challenging for your child?
Question 5 of 8
What are your concerns or target areas when it comes to your child's social skills?
Question 6 of 8
What are your goals for him/her? Do they have social goals as well?
Question 7 of 8
How did you hear about Starfish Social Club?
Thank you!
You will receive an email to schedule your 1/1 appointment next!