Please complete the intake form below. This information will help us understand your family's needs and how Faith over Fear Autism Supports can best assist you. Once submitted, you can expect a call from us within 48 hours.

We will collect the following information:

• Intake Details: Date, and who is completing the form (Parent, Guardian, Caregiver, Other).
• Parent/Guardian Information: Full name, preferred name, phone number, email address, preferred contact method (Call, Text, Email), and preferred contact time (Morning, Afternoon, Evening).
• Address / Service Area: City, County, Zip Code, and confirmation if you live in Georgetown, SC or surrounding areas.
• Child Information: Child’s name (or initials), age, date of birth (optional), gender, diagnosis (Autism (ASD), ADHD, Speech Delay, Nonverbal/Minimally verbal, Sensory Needs, Other), and date of autism diagnosis (if known).
• School / Education Information: Child's enrollment in school/daycare, school/center name (if applicable), classroom type, existence of an IEP/504 Plan, and if help is needed with IEP/school concerns.
• Services & Support: Current services received (ABA, Speech, OT, PT, Counseling/Behavior, None), if services have ever been denied, and what was denied.
• What Support Do You Need?: Top needs (Parent support group connection, ABA guidance/denials, IEP support / school advocacy, Childcare vouchers/scholarships, Help finding providers/resources, Emotional support, Sensory items/resources, Transportation support, Other).
• Support Group Preferences: Interest in attending a Parent Support Group, preferred meeting type, best days to meet, and best time to meet.
• Additional Information: Your biggest challenge right now, and what you would like Faith over Fear Autism Supports to help with first.
• Consent / Permission: Acknowledgement that Faith over Fear Autism Supports is not a medical provider or law firm, agreement to be contacted, and permission to send autism resources and event updates.

Thank you for trusting us to support your journey!