Apply for a consultation here!

Please take a few minutes to answer these questions thoughtfully and honestly. Your answers will always remain 100% private.

This is just an application! From here, a director will contact you to set up a quick phone call to see if a consultation will be the right move for your family.

What are the top 3-5 things you see your child struggling with right now? *

#1
#2
#3
#4
#5

Overall, on a scale from 0-10 (10 being the most severe,) how severely would you say your child is struggling right now? *

What, if any, interventions have you tried to help your child, and how did they work so far? *

Do you believe that there are any other issues at play aside from your child's brain function? If so, what are they? *

What recent situation made you realize "wow, we need help and we need it now"? *

First Name *

Last Name *

Phone *

Email *

I agree to the privacy policy provided by Delta Genesis. By providing my phone number, I agree to receive texts from Delta Genesis.

*We will only ever text you about your appointments! No spam - we promise!