Parent Contact Form

I am a...

Parent
Grandparent
Foster or Adoptive Parent
Primary Caregiver

(Check as many as apply)

I care for:

a child whom I think might have autism
a child who has an autism spectrum diagnosis
a teen or adult whom I think might have autism
a teen or adult who has an autism spectrum diagnosis

The autistic spectrum includes such diagnoses as: ADHD, Asperger's, Dyscalculia, Dyslexia, Dyspraxia, Kanner's, OCD, PDD-NOS, and Tourette's. Females in the spectrum are often misdiagnosed with Anxiety/ Panic Disorder, Bipolar, Eating Disorder, Fibromyalgia, and OCD.

The need or frustration which brought me here today is...?

I"m seeking support for:

myself alone
my immediate family
my extended family
my community of friends and supporters

The specific events, issues, or concerns about the future I'd like to find support around include:

My current top goals for my child's health and happiness are:

Name*

First Last

Email*

Because I have autism and the associated heightened variability in daily function, I am not on the computer every day. Thank you for your patience.

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Please note: Your name and email will only be used to contact you directly. Your information will not be added to my newsletter mailing list unless you select that option below.

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