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First Name of Parent or Guardian

Last Name of Parent or Guardian*

Name of Student

Street Address

Address line 2

City

State

Zip Code

Email

Phone

Is your student currently enrolled in a public school?

School District

What grade is your student currently enrolled in?

Does your student have an IEP (Individualized Education Program)?

What types of solutions are you looking for?

I would like the district to make up for service minutes they failed to provide

I would like my child to be placed in a less restrictive learning environment

I would like a new IEP and/or BIP to be written

Other

How did you hear about IEP Defenders/Lex Tecnica?

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