Child's Home State
Have you taken a tour of HHC?
HHC offers tours Wednesdays at 9:30. please call 614-262-7520 to set up a time.
I am interested in receiving the following Education Center service:
Does Your Child Have a Current Diagnosis?
If Yes, What Is/Are Your Child's Diagnosis?
Does your child have an IEP?
If yes, Is the diagnosis listed on the IEP/ETR?
What grade level is indicated on IEP?
If No, Please Describe Your Child's Needs:
Has Your Child Attended School?
If Yes, What Type of Classroom, What School, What District and What Duration?
What Goals Do You Expect Helping Hands to Meet During School Year?
Therapy and school services (and service provider) my child is currently receiving: (i.e. Speech, OT, PT etc.)
Child's Strengths (what is he/she good at?):
Child's Deficits (what does he/she have difficulty with?):
Behaviors (acting out, self-injurious, preservative, etc.):
Funding Source We Want to Utilize:
Funding Source We Want to Utilize 2:
Funding Source We Want to Utilize 3:
Funding Source We Want to Utilize 4:
Funding Source We Want to Utilize 5: