Schedule a Tour

• Tours are generally scheduled on Tuesdays and Thursdays between the hours of 9am - 11am. If these times and days are not best for you, please request a different time and day below.

• Schedule a Tour 
• 1st Preferred Time
   / Month  / Day Year

  at

       : Hour Minutes AM PM        
• 2nd Perferred TIme
   / Month  / Day Year

  at

       : Hour Minutes AM PM        
• Parent/Guardian's Name*
  First Name Last Name
• Address

  Street Address
  Street Address Line 2
  City	State / Province
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• Phone Number*
  - Area Code Phone Number
• E-mail*
• Concerns and goals for your child
• Student's Name*
  First Name Last Name
• Student's Age/Grade*
• Grade Level Funtioning*
  Reading Math
• Current School
• Last Year's School (if different from current)
• Are you thinking of changing schools now?
  Yes No
• Presenting Issues
  Academic Social Behavioral
• Other Presenting Issues
• Do you have testing?
  Yes No
• If yes, please give source
• Current Medications (if any)
• Outside Therapies
• Referred by:
  School Diagnostician Therapist Doctor Other
• Name of Person who referred you to Merit Academy
• Submit
• Should be Empty:

Or call us at 214-736-8375.