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*

Email*

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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