Make a Referral

Thank you for your interest in Atideinu for a child. Please complete the following form and one of our team will be in touch.

Child's name*
Grade*
School*
Your name*
Relationship to child*
Your phone number*
Your email address*
Best time to contact*
Why do you think Atideinu is a good fit for the child?*
List three areas of growth that you think Atideinu can foster in the child.*
Confirmation*
- I understand that Atideinu is designed to meet the needs of children who are functioning well academically, socially, and emotionally. I understand that Atideinu is not a behavior management solution or a treatment for mental illness and is not appropriate for children in need of clinical intervention.
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