Questions about BrainSTEPS CO?

Contact:

Toni Grishman
Email:
[email protected]

Jody Dickerson
Email:
[email protected]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Refer A Student to BrainSTEPS CO

Fill out the following form to refer a student to the BrainSTEPS CO program. All referrals to BrainSTEPS CO should only be made after receiving parent approval. Fields with a light-yellow background are required. The information you enter will be submitted to the appropriate BrainSTEPS CO team in the student's geographic area. Once your student referral has been electronically sent to the BrainSTEPS team, please allow several days for the team leader to contact the parent and school.

Student:
 (e.g. 01/01/2009)

  Referral Contact Information:
  Primary Parent Contact Information:
 
 
 
 
  School Contact (if you have this information):
 
 
 
  BrainSTEPS:

(ex. 01/01/2009)