Client Forms

Please complete the following documents and return them to our office prior to (or at the time of) your appointment.
Note that Word documents take longer to open.

CLIENT INFORMATION SHEET

Please complete all sections that apply to the client referred for services.

TEACHER INPUT FORM

Please make as many copies of this form as necessary and have them completed by the teachers who are working with (or have worked with) the student.

PARENT INPUT FORM

Parents should complete this form based upon their observations of the child at home and the feedback they have received about the child from teachers.

EDUCATIONAL RECORDS

Please make a complete copy of the client’s educational records and put them in chronological order from the oldest (top) to the current (bottom).

FEE POLICY

Please sign, date and return these forms to the office at the time of your first appointment. If you would like to have copies for your records, we will provide them.

CONSENT FORMS

Please sign, date and return this form to the office at the time of your first appointment. If you would like to have a copy for your records, we will provide it.

Microsoft Word Format	.PDF Format
Forms to Schedule an Appointment	Forms to Schedule an Appointment
Adult & College Student Intake form	Adult & College Student Intake form
Generic Intake Form	Generic Intake Form
Client Intake Form for Children & Students	Client Intake Form for Children & Students
Parent Input Form	Parent Input Form
Teacher Input Form	Teacher Input Form
Consent for Treatment	Consent for Treatment
Consent to Use & Disclose Healthcare Info	Consent to Use and Disclose Healthcare Info
Contract for Adult Evaluation	Contract for Adult Evaluation
Contract for Private Pay IEE	Contract for Private Pay IEE
Cover Sheet for IEE Private Pay	Cover Sheet for IEE Private Pay
Tutoring Fee Policy	Tutoring Fee Policy
MJK Fee Policy	MJK Fee Policy
Notice of Privacy Practices	Notice of Privacy Practices

Forms for District Funded IEE's	Forms for District Funded IEE's
Contract for School District IEE with Observation	Contract for School District IEE with Observation
Contract for School District IEE without Observation	Contract for School District IEE without Observation
Cover Sheet for District for IEE at District Expense	Cover Sheet for District for IEE at District Expense
Cover Sheet for Parent for IEE at District Expense	Cover Sheet for Parent for IEE at District Expense
IDEA 2004 Statute for IEE	IDEA Statute for IEE
Districts that have Contracted for IEE's	Districts that have Contracted for IEE's
Educational Hearings in which MJK has Testified	Educational Hearings in which MJK has Testified
OSEP Criteria for IEE	OSEP Criteria for IEE
VITA Margaret Kay	VITA Margaret Kay
Directions to Office	Directions to Office
Restaurant Guide	Restaurant Guide

Retainer Contracts	Retainer Contracts
Retainer Contract for Educational Due Process	Retainer Contract for Educational Due Process
Retainer Contract for Telephone Testimony	Retainer Contract for Telephone Testimony
Retainer Contract for School Observation	Retainer Contract for School Observation
Retainer Contract for Presentation	Retainer Contract for Presentation

EDUCATIONAL RECORDS

Please make a complete copy of the client’s educational records and put them in chronological order from the oldest (top) to the current (bottom).

Send mail to MJK@MargaretKay.com with questions or comments about this web site.

Last modified: January 03, 2008

EDUCATIONAL RECORDS Please make a complete copy of the client’s educational records and put them in chronological order from the oldest (top) to the current (bottom).

Send mail to MJK@MargaretKay.com with questions or comments about this web site. Last modified: January 03, 2008

EDUCATIONAL RECORDS

Please make a complete copy of the client’s educational records and put them in chronological order from the oldest (top) to the current (bottom).

Send mail to MJK@MargaretKay.com with questions or comments about this web site.

Last modified: January 03, 2008