Synergy Space — Contact & Inquiry

Response time: typically within 1–2 business days.

Progress 0%

Website

Contact Details

Parent / Guardian Name *

Email *

Phone (optional)

Used only if email fails or you request text follow-up.

Time Zone *

About Your Child

Child’s Name *

Age Range *

What are you seeing most often? *

Select all that apply.

MeltdownsEscalation, yelling, crying, throwing, panic.

ShutdownsFreezing, withdrawing, refusing, going silent.

TransitionsDifficulty leaving, switching activities, bedtime, school.

Impulse ControlHitting, grabbing, unsafe choices, blurting.

Executive FunctioningPlanning, follow-through, flexibility, memory.

Sensory OverwhelmNoise, clothing, crowds, touch, food textures.

How often does this happen? *

Where is it most disruptive? *

What outcome are you hoping for? *

Examples: smoother transitions, faster recovery, more flexibility, fewer escalations, more independence.

What have you already tried? (optional)

Routines, rewards, therapy/OT history, school supports — what helped or didn’t help.

Quick Message

Anything else you want us to know? (optional)

If you’re reaching out for something outside the checkboxes, add it here.

Safety Check *

If “Active crisis” is selected, the next step will be referral resources rather than coaching.

By submitting, you agree this is not emergency support and you’re seeking structured skill-building, not therapy.

This website is not for emergencies. If you are in immediate danger, call 911 (US) or your local emergency number.

Let’s start with the basics, then get clarity.