Parent/Guardian(s) name(s):(Required)

Phone(Required)

City of Residence(Required)

Note: Parent education evenings currently only available at the Guelph VUE Clinic location

Age of Child(Required)

Grade(Required)

Formal IEP (individualized educational plan) in place?(Required)

Please Indicate Type(Required)

Main area(s) of concern(Required)

(example: reading difficulty, frustration with reading, spelling issues etc.)

Tell us about your child’s current struggles and how it is affecting them and also the family as a whole(Required)

Dates of Upcoming Events - Please Select Your Preference(Required)

The presentation is expected to be 60 minutes with 30 minutes for questions.

Patient Education Evening Registration Form

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