I am excited to be working with you on time management and organization support.

Below, you will find a link to all of the forms that will need to be completed before our first session.

Should you have any questions about the forms, reach out to Jenny via email at jenny@ponzuriclearningsolutions.com or by phone (818) 481-6089.

I look forward to our work together.

Form #1: Consent to the intervention sessions

Please download, print, and sign this document. Scan and email me the signed page.

If you wish to sign documents electronically, please send me an email at jenny@ponzuriclearningsolutions.com

Download Consent Form

Form #2: Email Authorization

Please let me know if you agree to communicate via email. Download, print and sign this form; then scan and email it back to me.

If you wish to sign documents electronically, please send me an email at jenny@ponzuriclearningsolutions.com

Email Authorization Form

Form #3: Social Media Policy

Download, print, and sign the social media policy document. If the student is over the age of 13, please have them sign as well.

If you wish to sign documents electronically, please send me an email at jenny@ponzuriclearningsolutions.com

Download Social Media Policy

Form #4: Notice of Privacy Policies

Please download, review, and print the notice of privacy policies. Sign, scan, and email back to me.

If you wish to sign documents electronically, please send me an email at jenny@ponzuriclearningsolutions.com

Download the Notice of Privacy Policy

Form #5: Release of Information

If you believe there is anyone you would like me to contact as part of the intervention process, including the school, specific teachers, therapists, etc., please download and sign the attached form. Complete one for each person you would like me to contact.

Download the Release of Information Document

Form #6: Background Information

Please download and complete the attached form to the best of your ability. This provides me with some background about your student that I find helpful as we work together.

Download the form, complete it and then scan/email the document back to me.

Download the Background Form