Workshop Request Form | Pediatric Neuropsychology Associates

We welcome requests for customized talks and workshops for schools, parent groups, clinicians, and community organizations. Please complete the form below to help us better understand your goals and audience.

Audience

Format & Topics

Scheduling

Contact

Review

Who is the intended audience? (required) (Check all that apply) Parents and caregivers School staff (teachers, counselors, administrators) Clinicians or healthcare professionals Students General community or organization

Content Level (required) Introductory / Foundational (For audiences with little or no prior knowledge — e.g., parents, general educators) Intermediate (For audiences with some familiarity — e.g., school professionals, general clinicians) Advanced / Specialized (For expert audiences — e.g., psychologists, neuropsychologists, seasoned clinicians) Flexible — can be tailored based on audience

Preferred Format (required) In-person presentation Virtual (Zoom or other platform) Hybrid (some in-person, some virtual)

Topics of Interest (required) (Check all that apply) Understanding ADHD and executive functioning Supporting children with Autism Spectrum Disorder (ASD) Learning differences and academic support strategies Supporting cognitive and adaptive skills in children with intellectual challenges Neuropsychological evaluations: process and benefits Collaborating with schools for effective accommodations emotional regulation and behavior management strategies Custom topic (please describe below)

Custom Topic / Additional Details

Preferred Length (required)

30 minutes 60 minutes 90 minutes Half-day Other

Preferred Dates/Times (required) (Check all that apply)

Weekday mornings Weekday afternoons Weekday evenings Weekends

Preferred Date

Estimated Number of Attendees (required)

Fewer than 10 10–25 26–50 51–100 More than 100

Location (if in-person)

Additional Details or Specific Requests

Name (required)

Organization (if applicable)

Email (required)

Phone Number (optional)

Preferred Contact Method (required)

Email Phone

Please review your request before submitting.

Thank you for your request! We will review your submission and be in touch soon.

Thank You!

Your workshop request has been received.

A confirmation email has been sent to your inbox. Please check your email (including spam/junk folders) for a copy of your submission.

What Happens Next

We'll review your request within 2–3 business days
A team member will contact you to discuss availability and details
We look forward to presenting to your group!

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Workshops and presentations are educational in nature and are not a substitute for individualized evaluation, diagnosis, or treatment. Submission of this form does not guarantee availability.

Workshop & Speaking Engagement Request

Request a Workshop or Speaking Engagement

Thank You!

What Happens Next