Free Reading Assessment & Parent Consultation

FREE ONLINE READING ASSESSMENT

Submitting this short interest form (it only takes about 3 minutes) ensures that your child will be scheduled for their free reading assessment (including an optional dyslexia screening), your parent consultation, and helps me to prepare for it. Please note that assessments and reading lessons are held virtually on Zoom by appointment only. The assessment also allows you to see how effective online teaching and learning can be. (See improved reading in 10-12 lessons!). If you have more than one child, please submit a separate form for each child. Once you submit your form, you will receive a confirmation email with the next steps.
If you need assistance, please email me here or contact me at 718-496-8126. Be sure to leave a voicemail or text message.

To watch me teach and see how effective teaching and learning online can be, head over to my Google business page and take a look. Click here.

Visit my website here to find out more about me and my services.
Child's Name*

First Name or InitialMiddle Name or InitialLast Name
Child's Birth Date*

MonthDayYear
Child's Grade*
If known, please include their reading grade level. EX: grade 4 / level D
What school does your child attend? (optional)
HomeschooledPrivatePublicCharterPre-schoolNot in schoolOther
In a few words, tell me about your child's reading challenges and needs. What are their most challenging areas when it comes to reading/literacy? (Ex: letter sounds or recognition, sight word recognition, phonemic awareness, fluency, reading comprehension, vocabulary, reading with confidence, etc.) This is also for parents who have a child under 5 who needs to learn fundamental pre-reading skills.
Decoding/Sounding out wordsFluency/Reading more smoothlyReading comprehensionIncreasing vocabularyPhonemic awarenessPhonicsReading with confidencePre-reading skills (for early readers)Sight-word recognition (for early readers)Letter sounds or letter recognition (for early readers)Other
Mac desktop computerOther desktop computerMacBookOther laptopIPadOther tabletSmartphoneOther
Does your child have any diagnoses? (yes or no)*
YesNoI will decide on the day of the assessment
YesNo
What reading level did your child's classroom teacher say they are? *
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Email*
example@example.com
Child's Email (if applicable)
example@example.com
Address (optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's telephone number*
EasternCentralPacificMountainOther
MondayTuesdayWednesdayThursdayFriday
Morning WeekdayAfternoon WeekdayAfter school/Evening weekdayNone of these work-I’ll suggest a time below
Please suggest another day/time that works for you - if applicable.
During the entire school yearDuring the entire school year including the summerDuring the summer session only
I was referred to youWe met in personAt an event (in-person or online)A Facebook groupA posted flyerYour websiteLinkedIn.comNextdoor.comTutors.comWyzant.comGoogle searchCraigslist.comCare.comOther
Is there anything else you’d like me to know?
Should be Empty:

FREE ONLINE READING ASSESSMENT