Date of Consultation

Email Address: Educational Liaison & Program Manager

Consult Source

Location Type

—Please select—Public School District, School SiteCharter, Private, HomeschoolDCS OfficeUnknown or Other

Specialist Type

—Please select—DCS: InvestigationsDCS: OngoingDCS: AdoptionsDCS: Young Adult ProgramDCS: ICWADCS: Other ProgramSchool StaffPlacementOther

Office Address

—Please select—


APACHE JUNCTION REGIONAL – 1355 S Clearview Ave Ste 300 Mesa AZ 85209AVONDALE – 965 E Van Buren St Ste 100 Avondale 85323BULLHEAD – 2440 Adobe Rd Ste 104 Bullhead City AZ 86442CASA GRANDE – 1119 E Cottonwood Ln Casa Grande AZ 85122COTTONWOOD – 1500 E Cherry St Ste B Cottonwood AZ 86326DOUGLAS – 204 W 5th Street Ste A Douglas 85607FLAGSTAFF – 2705 N 4th Ave Flagstaff AZ 86004FREDONIA – 432 N Main St Box 555 Fredonia AZ 86022GILBERT – 1201 S Alma School Rd Floor 6 Mesa 85210GLENDALE/PERMANENCY – 5800 W Glenn Dr #150 Glendale 85301GLOBE – 605 S 7th St Globe AZ 85501KINGMAN – 2400 Airway Ave Kingman AZ 86409LAKE HAVASU / PARKER – 1755 N Mcculloch Blvd Suite 101 Lake Havasu AZ 86403MESA – 1 N Macdonald Mesa 85201PAGE – 1057 Vista Ave Po Box 567PAYSON – 100 N Tonto St Ste 102 Payson AZ 85541PEORIA – 8990 W Peoria Ave 2nd Floor Peoria AZ 85345PHOENIX NORTH CENTRAL – 3221 N 16th St Ste 400 Phoenix AZ 85016PHOENIX OSBORN – 3550 N Central Ave 3rd Floor Phoenix AZ 85012PHOENIX PINNACLE PEAK – 1925 W Pinnacle Peak Rd Phoenix AZ 85027PRESCOTT / PRESCOTT VALLEY – 1211 E Gurley Prescott AZ 86305REGION – 1300 W University #100 Flagstaff AZ 86001SAFFORD 333 – N 8th Ave Safford AZ 85546SHOW LOW – 1600 E Woolford Rd Show Low AZ 85901SIERRA VISTA – 157 N Coronado Ste J Sierra Vista 85635SOUTH MOUNTAIN/PERMANENCY – 3925 E Broadway Rd Phoenix 85040SOUTHWEST REGIONAL – 3221 N 16th St Ste 400 Phoenix 85016ST. JOHNS – 1200 W Cleveland St #2 St Johns AZ 85936TEMPE / GILBERT – 1201 S Alma School Rd Suite 1100 Mesa AZ 85210THUNDERBIRD – 1925 W Pinnacle Peak Rd Phoenix AZ 85027TUCSON 4TH AVE – 2750 S 4th Ave Tucson 85713TUCSON 4TH AVE – 2760 S 4th Ave Tucson 85713TUCSON AJO WAY – 2225 E Ajo Way 85713TUCSON AJO WAY – 2329 E Ajo Way Tucson 85713TUCSON ALVERNON – 1455 S Alvernon Way 85711TUCSON BENSON – 443 W 4th St Benson 85602TUCSON BROADWAY – 4400 E Broadway Blvd Suite 118 Tucson 85711TUCSON BROADWAY – 6840 E Broadway Blvd 85710TUCSON CONGRESS ST – 400 W Congress St Suite 420 85701TUCSON COUNTRY CLUB RD – 6363 S Country Club Rd #151 85706TUCSON EASTSIDE – 1450 S Eastside Loop Tucson 85710TUCSON ORACLE – 3550 N Oracle Road Tucson Arizona 85705TUCSON SANTA RITA AVE – 4201 S Santa Rita Ave Ste 105 Tucson 85714TUCSON VALENCIA – 3000 E Valencia rd Ste 100 Tucson 85706WEST 101 – 1860 N 95th Ln 2nd Floor Phoenix AZ 85037WINSLOW – 219 E 3rd St Winslow AZ 86047YUMA – 1800 E Palo Verde Ste B Yuma 85365Other

Student Information

Grade

—Please select—Pre-KK123456789101112Post-SecondaryGEDHomeschoolUnknown

School Name

Placement Type

—Please select—Group HomeKinshipFoster HomeResidential Treatment CenterShelterParent/Family of OriginIndependent LivingUnknownOther

Student County

—Please select—MaricopaPimaYavapaiOther

Please select the county where this student is currently living.

Educational Concerns

Please select all that apply.

School mobility: transportationImmediate enrollmentEnrollment in appropriate school, grade, coursesObstacle to IEP/504Retention process supportSchool discipline/Behavioral concernPost-graduation planning and options counselingCredit recoveryBest Interest Determination SupportOther educational concern

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Consult Outcome