Brave Hearts Connection Form

For Educators & Schools

Welcome, and thank you soulfully for your commitment to supporting the hearts and minds of young children. This connection form is designed to help me understand how I can partner with you or your school in ways that uplift emotional regulation, connection, and classroom community. Whether you’re an educator, administrator, counselor, or a school leader, I’m honored to collaborate with you.

Please feel free to answer with as little or as much detail as you wish — this is a safe space to be honest, curious, and supported. 💖

Name

First Name

Last Name

Phone Number

(###)

###

####

Preferred method of communication

Text

Phone Call

Your Role

What age group or grade level do you primarily work with?

How many darlings are typically in your care or within your focus group?

What are some strengths you see in your classroom or school environment?

What are some recurring challenges — emotionally, behaviorally, or socially — that you'd like support with?

How do your students typically respond to stress, transitions, or frustration?

What self-regulation or co-regulation tools are currently being used (if any)?

Are there specific students you’re concerned about emotionally or behaviorally (without using names)?

What support do you feel *you* need as an educator or school leader right now?

What kind of Brave Hearts support are you interested in?

Would this be for...

Preferred Format:

Is there a specific time of week, or day that works best for you or your school?

Is there anything else you’d like me to know before we connect?

If your school could experience a shift in one emotional area, what would it be?