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New Student Information Form

Parent or Guardian Information

Preferred Method of Contact

Student Information

About Your Child’s Learning Needs

Additional Information (Optional)

Has your child received any prior academic support?

Scheduling Preferences

Preferred Tutoring Format
Preferred Days
Preferred Time of Day
Desired Frequency

Next Steps

Have you already scheduled a consultation?
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Disclaimer: Math Mindset LLC provides academic support and specialized math instruction but does not diagnose learning disabilities or conduct formal psychoeducational evaluations. Our services are not a substitute for assessments performed by licensed psychologists, educational diagnosticians, or medical professionals. If you suspect a learning disability or require a formal diagnosis, we recommend consulting a qualified professional or your local school district’s special education department.

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