Email*

Parent's Full Name*

Phone number

Student's Current Grade Level

Presenting Challenges*

Too much time spent on screens

Constant prompting about school work

Cramming for tests

Loss of focus and forgets about homework and assignments

Little to no motivation to read

Disorganized backpack, gdrive and study space

Avoidance of school responsibilities

Procrastinating on starting or finishing homework

Parent-Child Dynamics

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