Online MNRI Assessment Appointment Requests

Online MNRI Assessment Appointment Requests

The Svetlana Masgutova Educational Institute is accepting appointment requests for our Online MNRI Assessment program.

Appointments will occur over Zoom. You can download Zoom here: https://zoom.us/

Appointments are $650.00 per session.

Appointments will be 45 minutes long. Each additional 5 minutes will cost and additional $80.00.

You must complete the Participation Agreement form in order to participate in the Online MNRI Assessment program.

You must also upload videos as described in the form below to be eligible for an Online MNRI Assessment

Please note:

*Submitting this request for an online MNRI assessment does not guarantee the date or time you requested. We will do our best to accommodate every request.

*We will contact you within 1-3 days after you submit your request to complete registration for your online MNRI assessment.

*Questions? Please email Candice Allain, Program Manager, at candice@masgutovafoundation.org

* : required
Patient Name:*
Patient Age:*
When was patient's last MNRI assessment?*
When was patient's last MNRI Family Education conference?*
Guardian Name:*
Phone Number:*
Email Address:*
Requested date of Online Consultation (We will do our best to schedule you the requested date or call you to choose one very close to it):*
Requested time of Online Consultation (We will do our best to schedule you the requested time or call you to choose one very close to it):*
Please provide a video of your child performing **insert description here**.:*
Please provide a video of your child performing **insert description here**.:*
Please provide a video of your child performing **insert description here**.:*
Please provide a video of your child performing **insert description here**.:*

Please complete the visual confirmation*