Get Confidential Questionnaire - Dyslexia

This guide provides clear instructions for filling out the Confidential Questionnaire - Dyslexia online. Use this tool to ensure all necessary information is accurately recorded for assessment purposes.

Follow the steps to fill out the Confidential Questionnaire - Dyslexia online.

1. Click the ‘Get Form’ button to obtain the form and open it in your browser or designated editing tool.
2. Begin by filling in the personal details of the child, including name, date of birth, age, and gender. Make sure each field is completed accurately.
3. Provide the child's address and contact information, including phone number and email address.
4. Fill in the family information section, specifying the names and occupations of both parents, the number of children in the family, and the child's position within it.
5. Indicate if there are any family members with written language difficulties to help assess potential genetic factors.
6. Next, complete the school history section by providing the child's current school name and type (independent or state), along with any special circumstances affecting their development.
7. Assess and record the child’s attitude toward school, their difficulties, and the subjects they struggle with or excel in.
8. Detail any support the child has received from school and outside of school, including previous treatment from specialists or psychologists.
9. In the health and development section, document the child’s birth weight, health status, any allergies or serious injuries, and results of previous vision and hearing tests.
10. Answer questions regarding the child’s early development milestones, motor skills, language exposure, and memory or attention challenges.
11. In the emotional adjustment section, provide information regarding the child’s motivation, behavior difficulties, and social relationships.
12. Finally, describe the child's current difficulties and the reasons for seeking an assessment, then sign and date the form, specifying your relationship to the child.
13. After completing the form, save any changes, then download, print, or share the document as necessary.

Take the next step in your assessment process by completing the Confidential Questionnaire - Dyslexia online today.