Intake form

Name *

Email address *

What type of neurodiverse disability do you have?

Please select at least one option.

Autism Spectrum Disorder

Dyslexia

ADHD

Dysgraphia

Sensory Processing Disorder

What are your primary goals for using this platform?

Please select at least one option.

Improve writing skills

Enhance comprehension

Receive feedback on assignments

Develop organizational strategies

Increase confidence in writing

What age group do you belong to?

What educational level are you currently at?

What specific writing challenges do you face?

How did you hear about us?

What subjects do you need assistance with?

Please select at least one option.

English

Math

Science

History

Art

Do you require any specific accommodations while using our platform?

Which service or services are you interested in?

Please select at least one option.

Personalized writing assistance

Interactive feedback system

Goal-Setting and progress tracking

Additional questions or comments

ChatGPT for Neurodiverse Students