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First Name*

Last Name*

Preferred Language

Street Address*

Street Address Line 2

City*

State*

Zipcode*

Phone Number*

Email*

Your relationship to the student learner (Biological Parent; Grandparent; Foster Parent; Kinship)*

Have you worked with an Education Attorney or Advocate in the past?*

Child/Learner Full Name*

Date of Birth*

Current Grade*

Ever Retained (Held Back)?*

Current School*

School Status*

Support Status*

Current Medications*

Describe any current support outside of school: (Behavioral Health; Medical Team; Therapy; Family Based Therapy; Speech; OT; Social Skills)*

If the child/learner has an IEP, do you have a copy?*

If the child/learner has an IEP, what is the disability the District of Charter has indentified?*

Share Your Concerns*

Who at school have you shared these concerns with and a solution was offered (If any)?*

What solution would you like to see for your child/learner?*

Does your concern involve Notice of Expulsion or Removal to an alternative setting?*

Does your concern involve physical harm to your child in school (If so, have you alerted the school administration and child line)?*

HP Name

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Kimberly is an attorney specializing in educating students with disabilities across Pennsylvania with a focus on supporting families in Philadelphia and the southeastern part of the state.

This website provides general information and does not constitute legal advice. Using this site does not create an attorney-client relationship. Consult a licensed attorney for legal guidance.

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