MasterPeace Parent Empowerment Coaching

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Intake Form

Share your story and goals in a secure form so coaching starts focused on what matters.

A serene living room corner designed as a calming space for an autistic or learning-disabled child, featuring a large beanbag chair in muted teal, a soft gray weighted blanket folded neatly, and noise-cancelling headphones resting on a small round side table. Nearby, a low shelf holds neatly labeled bins with colorful but orderly educational toys and sensory materials. Natural daylight streams through sheer curtains, producing a soft, diffused glow and subtle shadows on the textured rug. Photographic realism, shot at eye level with a gentle wide-angle view, creates a peaceful, non-clinical atmosphere that feels supportive and nurturing, embodying the compassionate, evidence-informed environment encouraged by coaching.

Intake Details

Please answer as fully as you can; your responses guide a tailored, respectful coaching plan for your family.

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Thank you for your response. ✨

A modern digital tablet lying on a tidy kitchen island, displaying a blurred, colorful coaching worksheet interface, surrounded by subtle visual cues of family life: a bowl of fresh fruit, a child’s simple abstract drawing magneted on a nearby stainless steel fridge, and a small plant with glossy green leaves. Overhead pendant lights cast warm, even illumination, creating soft highlights on the tablet’s screen and smooth countertop. The photographic image is composed from a three-quarter top-down angle with a shallow depth of field, bringing attention to the tablet while allowing the home context to softly fade into the background. The mood is hopeful, practical, and grounded in everyday routines, showing how guidance integrates seamlessly into family life.

Why

This intake asks detailed questions so we can understand your child’s strengths, stressors, and supports, honor your family’s values, and design ethical, evidence-informed coaching that truly fits your neurodivergent child and your reality.

Learn why