Advocacy Intake Form

DSAMT provides educational advocacy support to parents of school-aged students. DSAMT's support includes parent consultations, including document/IEP reviews, and is overseen by our Policy & Advocacy Director, Erin Richardson. To request support, please complete the Intake Form below. You will be contacted by a DSAMT staff member within two business days after submission.

Parent Name

Phone Number

Address

City, State and ZIP Code

Child's Name

Child's Date of Birth

School District

School Student Attends

Student's Current Grade

Description of Issue/Concern

Does Student currently have an IEP?

YES
Student currently has an IEP
NO
Student currently does not have an IEP

If the Student Has an IEP, Please Attach

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