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How to fill out the Dyslexia Referral Form online
Filling out the Dyslexia Referral Form online is a crucial step in seeking support for a student who may be experiencing reading difficulties. This guide will walk you through the process, ensuring that you complete each section accurately and effectively.
Follow the steps to successfully fill out the Dyslexia Referral Form online.
- Press the ‘Get Form’ button to access the Dyslexia Referral Form and open it in your preferred digital form editor.
- Enter the student’s name, ID number, and date at the top of the form, ensuring all details are accurate.
- Fill in the student's date of birth and gender information in their respective fields.
- Indicate the student's grade level and the name of their current school, followed by the classroom teacher’s name.
- Proceed to Section A: Teacher’s Evaluation. This section should be filled out by the student’s classroom teacher. In the first question, specify the reader level the student can read with reasonable fluency, noting the assessment used, the date, and the level achieved.
- Rate the student on the outlined characteristics of dyslexia, selecting 'Always', 'Sometimes', or 'Never' for each characteristic accordingly.
- Next, move to Section B: Other Observations. If there are any at-risk factors that you are aware of, provide a brief description in the designated area. If there are none, leave this section blank.
- Indicate if there is a family history of reading difficulties by selecting either 'Yes' or 'No'. If 'Yes', provide further explanation as needed.
- Submit 3-4 dated examples of the student’s work that may help determine their eligibility for dyslexia services, such as a spelling test or writing sample. Avoid submitting workbook packets.
- Once all sections are completed, review the form for accuracy before saving your changes. You can download, print, or share the completed Dyslexia Referral Form as needed.
Complete your Dyslexia Referral Form online today to ensure timely support for your student.
To obtain proof of dyslexia, you will need to have a formal evaluation completed by a qualified professional. The results of this assessment will provide documentation of the diagnosis, including findings related to the Dyslexia Referral Form you completed before the evaluation. This proof can be essential for accessing educational resources and accommodations. Make sure to request a copy of the assessment report for your records.