Red Oak Autism Academy Compatibility Application
This is the first step for joining the Red Oak Autism Academy family. Please take a few minutes to answer these questions about your child. This form is to help us determine if our school could be a good fit for your child as we try to do our best to accommodate each student. Once the form is complete and submitted, we will contact you within a few days to discuss the next steps. Please note - we cannot schedule a tour without an IEP, MET, or Medical Evaluation showing an autism diagnosis for your student. Additionally, the student must be present on the tour before being assessed for enrollment here at Red Oak Autism Academy. Thank you for your understanding.
Today's Date
Parent first and last name
Please enter your child's first and last name.
Please enter the interested grade level for your child. *Please note: we do not accept children for kinder that are under five years old.*
Kinder (starts at 5 years old)
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent Email
Parent Phone Number
Where does or did your child attend school?
When are you looking to have your child enrolled?
Are there any important elements you are looking for a school to have for your child's schooling experience?
Does your child currently have one of these assessments or more?
MET/Evaluation Report
Individualized Education Plan (IEP)
504 Plan
Medical Diagnosis (by a medical provider)
Educational Diagnosis (by a public school)
None/Other
Please note - an autism diagnosis must be present on your child's documentation to be enrolled in Red Oak Autism Academy.
Tours cannot be booked until an IEP, MET, and/or Medical Evaluation documentation is received. Thank you for your understanding.
Please attach your MET documentation here, if applicable.
Upload File (MET)
Please attach your IEP documentation here, if applicable.
Upload File (IEP)
Please attach your Medical Diagnosis documentation here, if applicable.
Upload File (Medical Diagnosis)
Please attach your Educational Diagnosis documentation here, if applicable.
Upload File (Educational Diagnosis)
Is your child currently approved to receive services through the Division of Developmental Disabilities(DDD)?
Yes
No
Unsure
Does your child receive services (therapy, etc) that are paid for by their ESA or by private (out-of-pocket) funds?
Yes
No
Unsure
Based off the descriptions below, which level best describes your child's Autism?
Level 1 ASD - Requires Support This is the mildest form of autism. Children with level 1 ASD have a hard time communicating appropriately with others. For example, they may not say the right thing at the right time or be able to read social cues and body language. A person with ASD level 1 usually is able to speak in full sentences and communicate, but has trouble engaging in back-and-forth conversation with others. They may try to make friends, but not be very successful. They may also have trouble moving from one activity to another or trying new things. Additionally, they may have problems with organization and planning, which may prevent them from being as independent as other people their age. Level 2 ASD - Requires Substantial Support People with ASD level 2 will have more obvious problems with verbal and social communication than those diagnosed with level 1. Likewise, they will find it harder to change focus or move from one activity to the next. Children with level 2 tend to have very narrow interests and engage in repetitive behaviors that can make it difficult for them to function in certain situations. For example, they may pace back and forth or say the same thing over and over again. Level 3 ASD - Requires Very Substantial Support Level 3 is the most severe form of autism. Children in this category will have many of the same behaviors as those with levels 1 and 2, but to a more extreme degree.Problems expressing themselves both verbally and nonverbally can make it very hard to function, interact socially, and deal with a change in focus or location. Engaging in repetitive behaviors is another symptom of level 3 ASD. A person with ASD level 3 will have a very limited ability to speak clearly and will rarely start interactions with other people. When they do, they will do so awkwardly. Someone with level 3 will also respond only to very direct social approaches from other people.
Choose an ASD Level that best describes your child from the above paragraph.
Level 1 ASD
Level 2 ASD
Level 3 ASD
What communication skills does your child have?
How independent is your child in using the restroom? *Please note: ALL children must be independent in the restroom. We do prompt and give reminders throughout the day.*
How well does your child know about personal space and boundaries with others?
Yes, very well and all the time
Yes, most of the time
Some of the time
Needs work and reminders
Not so much, needs many reminders
Other
How long can your child currently stay seated for in a school/academic setting?
We understand that children with Autism may be physically aggressive towards caregivers or other children. Please explain any physical behaviors that your child may show in a school setting or around others in general.
How do you plan to fund your child's tuition?
Empowerment Scholarship Account Program (ESA)
School Tuition Organization (STO)
Private Pay (out-of-pocket)
Unsure at the moment. Please send me an email with some funding resources.
Other
Are there questions that you have for us? Please list them below and we will do our best to answer them :)
Please provide us with a few day's and timeframes you may be available to come take a tour of our school.
How did you hear about us?
Google
Facebook
Instagram
Referral
Other
Submit