Evaluation Request Form Please note that my in-person evaluation services are limited to the Central Florida area in most cases. However, phone and virtual evaluation services are available throughout Florida. Your Name (required) Your Email (required) Your Address (required) Your Phone Number (required) Child's Name (required) Child's Age (required) Your School District (required) Additional Information Who may I thank for referring you? (Name, Email, Phone Number) By checking the box you agree to the following terms. Checking this box indicates that you consent to this site storing and using your personal information to get back in touch with you. I will not send or share the data with any 3rd-parties. You agree to this site storing your mailing information, if you provide it, in order to send products and complete services as well. Intuitive Behavioral and Educational Strategies, LLC is not responsible for the actions of clients. Intuitive Behavioral and Educational Strategies, LLC is not responsible for costs incurred or chosen by clients after being given recommendations or advice. Payment is due when services are rendered. 48 hours notice is required in order to cancel an appointment with no penalty fee. Cancelling with 24 hours notice requires 1/2 of the full payment. No shows are required to pay the entire fee. No refunds once the appointment has begun.