I am interested in the Neurodivergent Parent Group Name * First Name Last Name Email * Phone (###) ### #### Location Of Group * Please indicate if you are interested in online or in person group options or both- select all that apply. In person- Shelbyville Zoom/Online Community location Availability for a group * When would you be available for group? During the week before Noon During the week Between 12-5pm During the week after 5pm Weekend Individual Group Needs * Please share a little about what you would like to get from this group as well as ages of your children. This will help us create groups that are beneficial to the individuals in the group. Thank you for your interest in our Neurodivergent parent group. If you have any additional questions you may email Jen Stephens at jennifer.stephens@stephensbehavior.org