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Getting Ready for Your Family Intake

Thank you for scheduling your family intake. This questionnaire gathers practical information so Syd can prepare and use the intake conversation to focus on your child. Because you already completed the Waitlist form, this version asks only about updates and details not already covered. It should take about 15–20 minutes. If you need to stop, reopen the form in the same browser; unfinished answers are stored only there.

About this intake

Parent or guardian completing this form

Email address you have used with Novinway

Is there another parent or legal guardian Novinway should include in intake communications?

A
B

Please list each child this intake will cover.

For each child, include their full legal name, the name they use, date of birth, and gender.

Please list each child’s current school, program, childcare setting, or homeschool arrangement.

Include the name of the school or program, grade or program level, and usual weekly schedule. If this does not apply, write “Not applicable.”

Who plans to join the intake, and what is each person’s relationship to the child?

Since you completed the Waitlist form, has anything changed about your contact information, care address, children receiving care, schedule, transportation, or matching requirements?

A
B
C