Your Information

South Suburban ChADD would like to know more information about the members and prospective members of our chapter.  Please share any information you can with us so that we can serve you better:

Please provide the following contact information:

  Street Address 
 Address (cont.) 
 Zip/Postal Code 
      Home Phone 

Choose one of the following options:

ADD Parent
ADD Adult
ADD Parent and Adult
Teacher or School Representative
Service Provider (Doctor, Psychologist, Couselor etc.)

South Suburban ChADD will do its best to answer any questions or address any comments that you have.  Please share any of these with us.  We are not always able to answer you questions over email, the best way to get you questions answered is to attend one of our meetings!  Also mention if you would like to be added to our emailing list.

Would you like to be added to our mailing list?

Yes No

Would you like to be added to our emailing list?

Yes No

Are you currently a member of ChADD?

Yes No

Select the services that are most important to you:

Parent Support Meetings            Adult Support Meetings    
Children's Support Group           Online Support Groups
Informational Speaker Meetings     Meetings with Video Presentations
Library Resources - Books          Library Resources - Videos         
Library Resources - Audio Tapes    Doctor Resource List             

What is the most important consideration for ChADD meetings?:

Do you consider it important to have the personal support of meeting face to face with someone knowledgeable in ADHD, such as occurs in a support group setting?

Yes No

Would you be interested in personal one on one meetings with the knowledgeable coordinators and volunteers of our chapters?  These would be free, one on one meetings where appointments would be need to be made in advance.fs

Yes No

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Lauren Torres
Copyright 2002 [South Suburban ChADD]. All rights reserved.
Revised: 10/08/03