Education-Relief, Inc. — Coaching Support Services
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Get in touch

Let's start a conversation.

You're in the right place. Let's take this one step at a time. Reaching out can feel overwhelming — and you don't need to have everything figured out. Just share what you can. We're here to listen, support, and guide you forward.

Parent & Caregiver Intake Form

About You
Preferred Contact Method
About Your Child
Current School Setting
Strengths First (Because they matter most)

What do they love? What are they naturally drawn to or good at?

Your Concerns & Priorities

What would you most like to see improve, change, or feel easier?

School Experience
How would you describe your current experience with your child's school?
Current Challenges

Behavior, emotions, peer relationships, bullying, learning, regulation, etc.

Support You're Seeking
What type of support are you looking for? (Select all that apply)
Background & History

Optional — share only what you're comfortable with.

What's Already Helping
Recent Changes

Moves, school changes, family changes, health concerns, etc.

Looking Ahead
Your Preferences

e.g., clear step-by-step guidance, emotional support, collaboration, structure, resources

Safety Check
Is your child currently safe at school and at home?
Connection
How did you find us, or who can we thank for connecting you here?
Final Thoughts

Your information is private and handled with care. After you submit, we will personally review your responses and follow up as soon as possible. Delivered directly to elainespedaba@gmail.com.