What is the MyMemoryMentor intake form?
The MyMemoryMentor intake form is an online, adaptive clinical intake form for identifying neurodivergent learners. It collects a full neurodevelopmental history from parents, caregivers, teachers or referrers across seven structured steps, then hands the practitioner or school a triaged pre-session case profile and recommends which screener to run first. It is built for Educational Psychologists, school psychologists, SENCOs, MTSS coordinators, Speech-Language Therapists and multi-disciplinary clinics.
7 structured steps
14–22 min to complete
9 clinical domains
HIPAA · UK GDPR · FERPA · POPIA
Adaptive branching + auto-save
E-signature consent
~25 min
History time saved per first session
7
Structured intake steps
9
Clinical domains synthesised
4
Compliance regimes: US, UK, ZA, AU
The first session runs as a data-entry shift.
Every first neurodevelopmental appointment opens the same way. Reconstructing history. Asking questions you already know how to ask. Re-keying information that already sits across three documents, four emails, and a couple of WhatsApp screenshots from the school.
The cost turns up everywhere. UK Educational Psychologists report burnout near 72%. US school psychologists work at roughly 1 to 1,127 students, more than double the NASP recommendation. SENCOs and MTSS coordinators describe drowning in paperwork they did not sign up for.
30 to 50%
of a typical first session goes to data collection instead of decision-making. Every learner whose path is delayed pays for that.
MMM field observations across 40+ UK, US and AU practitioners, 2024–2025. Full methodology on request.
Three steps from referral to a session that starts with a hypothesis.
Not in a future release. On every case, today.
Step 01 · Send
Send one secure link
Send the intake from your dashboard, or batch it to a whole year group in one action. No paper, no PDFs to chase, no re-keying at the front desk.
Step 02 · Capture
The family completes seven steps
Adaptive questions branch on the parent’s answers. Progress saves at every step. Consent for the correct jurisdiction is captured by e-signature at the end.
Step 03 · Open
Open a triaged case
Concerns, developmental history, family history and cross-domain flags arrive organised on your dashboard, with a recommended screener to run next.
Seven steps. One structured profile.
The conveniences practitioners expect from modern intake tools, tuned Each step maps to how clinicians actually build a picture, written in language a parent at 11pm can answer. Every field earns its place.
About you and the learner
Referrer details, learner demographics, date of birth, and first language at home. Language and EAL status are captured first because they are the most common confound in screening.
Demographics
Language / EAL
Country
Concerns and observations
Areas of concern, how long they have been present, impact on daily life, and a plain-language description of a typical difficult moment. This is the signal clinicians say they value most.
Presenting concern
Duration + impact
What’s been tried
Development and early history
Birth and pregnancy history, developmental milestones against typical ranges, and significant life events. This separates a specific learning difficulty from environmental factors and supports a constitutional-origin account.
Cross-Milestones
Birth history
Life events
Education
School type, year group, academic performance against peers, current support, and previous assessments. A dedicated home-education path adapts the questions for home-schooled learners rather than forcing them through school-shaped fields.
School + home-ed
Support in place
Prior assessment
Medical and sensory
Vision and hearing checks, medication, and any diagnosed learning, neurodevelopmental or mental health conditions with DSM-5-TR and ICD-11 references. Family history of neurodivergence is captured, since it is one of the strongest predictors.
Vision + hearing
Diagnoses
Family history
Strengths and goals
What the learner is good at, what they are proud of, the conditions that help them do their best, and what the family hopes to gain. This shapes intervention and pre-qualifies the evaluation.
Strengths
Best conditions
Goals
Consent and e-signature
The correct consent module loads for the family’s jurisdiction, covering HIPAA, UK GDPR, FERPA, COPPA, POPIA and the Australian Privacy Principles. Under-13 learners trigger verifiable parental consent. Signed electronically, dated, and logged.
Multi-jurisdiction
COPPA for under-13
E-signature
Same hour. Different output.
The session length does not change. What you do with it does.
A generic online form
Records what happened
MMM intake
Hands you a pre-clinical profile
A clinical instrument, built like the best intake software.
The conveniences practitioners expect from modern intake tools, tuned for neurodevelopmental precision.
01
Smart pre-visit capture
Adaptive, conditional questioning that branches on the parent’s answers. Plain language cuts over-reporting and noise. The form knows when to dig deeper and when to move on.
Each section sits on DSM-5-TR and ICD-11 frameworks but reads like something an anxious parent can actually finish. Auto-save and mobile-friendly design keep completion rates high.
Adaptive logic
Auto-save
Mobile-friendly
7-step flow
02
Structured clinical output
No raw PDFs to read. No 12-page narrative to skim. You get a clean, decision-ready summary organised by clinical domain, waiting on the dashboard before the session.
Every input maps to a lens: development, academic concerns, behaviour, family context, prior interventions and symptom timelines. Export as PDF, JSON, or a school-friendly format SENCOs can drop into existing SEN paperwork.
Domain-organised
Dashboard-ready
PDF · JSON export
03
Cross-domain pattern flags
Signals across learning, attention, language, behaviour and emotion are cross-referenced. When two domains co-occur in ways worth a closer look, you see it before the session.
This is the layer that catches what gets missed in minute fifteen. A working-memory dip beside a phonological flag. A quiet girl scoring high on inattentive markers. The engine surfaces it, you decide.
Cross-domain
Risk flags
Girls’ underdiagnosis
04
Screener routing, no cold start
The intake feeds straight into screener selection and assessment planning. One workflow, no copy-paste, no parallel systems in the background.
Based on the profile that emerged, the platform recommends which screener to run next across nine clinical domains: literacy, numeracy, written expression, attention, executive function, working memory, autism traits, and emotional wellbeing. Each handoff carries the context forward.
Screener routing
Multi-rater
Multi-jurisdiction consent
How the intake works inside a real practitioner workflow
Consider an Educational Psychologist who receives a referral on Monday. The school has flagged a Year 4 pupil for reading difficulties. The parent has signed consent. In the old workflow, that practitioner arrives on Wednesday with three documents to read, a verbal history to gather, and a session that effectively starts at minute twenty-five. The first hour produces fragments. The second produces a hypothesis. The report takes another six hours to write.
With the MyMemoryMentor intake, the same practitioner opens the dashboard on Wednesday morning to a structured profile. The parent has already answered targeted questions about milestones, family literacy history, school observations and prior interventions. The engine has flagged a working-memory pattern that tracks with the reading concern. The school’s own observations sit alongside the parent input. The session opens with a clinical question, not a clerical one.
Why this matters for SENCOs and Heads of Inclusion
Ofsted judges inclusion as a leadership outcome now, not a SEN-team afterthought. A SENCO who can show early identification with structured evidence carries a stronger story into governance meetings and EHCP applications. The intake produces a paper trail aligned with the SEND Code of Practice, and it keeps parents inside the loop, which is the part most rushed processes lose first.
Why this matters for US school psychologists and MTSS coordinators
The shortage is real. NASP recommends 1 to 500. The national reality sits closer to 1 to 1,127. Mandates around MTSS and IDEA keep expanding. School psychologists are asked to evaluate more, document more and intervene more, without more clock. A structured intake reclaims the hours that disappear into history forms, parent calls and paperwork the IEP team will not read twice.
Why this matters for multi-disciplinary clinics
Clinics running combined psychology, speech-language and occupational therapy lose real time to duplicated intake. The same family answers the same developmental questions across three forms. The MMM intake routes one shared profile across the team, with discipline-specific extensions. The parent answers once. Each clinician gets the depth they need. Front-desk staff stop fielding calls about which form goes where.
High volume. High stakes. High signal.
For practitioners
Educational Psychologists, Clinical Psychologists, Speech-Language Therapists and specialist teachers running private or NHS-adjacent caseloads.
For schools
SENCOs, Heads of Inclusion, MAT inclusion leads, MTSS coordinators and district SpEd directors managing identification at scale.
For clinics
Multi-disciplinary teams running combined psychology, speech-language, occupational therapy and educational assessment.
Measurable, not theoretical.
HIPAA
UK GDPR
FERPA
COPPA
POPIA
APPs
WCAG 2.2
Straight answers before you trial.
When you open the next case, arrive at the answer.
Run the intake on three learners this week. Notice what your session opens with. That is the smallest version of the shift, and it is the version that proves the rest.
✓ Full intake engine
✓ Structured reports
✓ Screener routing
✓ Practitioner dashboard
If your first session opens with questions you already know how to ask, your expertise is doing the wrong job.
Open it with the history already structured and the patterns already flagged, and your judgement meets the case at full strength from minute one.