Request Step Up Tutoring or an Educational Evaluation

Use this form to start an inquiry with Accessibility Clinic Inc., a 501(c)(3) nonprofit organization. Please share only what is needed for us to make initial contact.

Before you submit

Please do not submit medical records, diagnoses, Social Security numbers, insurance or Medicaid numbers, banking information, IEPs, or other sensitive records through this initial contact form. If documentation is needed later, we will ask for it through a secure channel.

Submitting this form is an initial inquiry. It does not guarantee eligibility or funding, and it does not by itself establish a professional or client relationship.

Your name (required)

Email address (required)

Phone number (optional)

Only if you would like a call.

If other, please describe (optional)

What are you requesting? (select at least one)

Choices help us route your inquiry. Selecting an option does not mean every service is available in every location or circumstance.

Step Up tutoring

Educational evaluation or consultation

Assistive technology support

Other / not sure

Funding or scholarship program (required)

If you are not sure, choose "Unsure / other" and we will help you work it out.

Step Up For Students

FES-UA (Unique Abilities)

New Worlds Reading

PEP (Personalized Education Program)

Private pay

Unsure / other

General service location (required)

City and state. Please do not include a street address.

Preferred contact method (required)

Phone

Either

What help are you looking for? (required)

A short, general description is enough. Please leave out diagnoses and clinical detail.