Dyslexia Compass Registration

Full Name*

First NameLast Name

Email*

example@example.com

Phone Number

City/Town

Province or Territory*

I am requesting support for:*

My child (select this if you are the parent, family member, or guardian)MyselfMy student (select this if you are an educator, tutor, or teacher)My patient/client (select this if you are a medical doctor, psychologist, or social worker)A person with dyslexia (not myself)Other

In what school board is the child/student registered?

What type of school is your child enrolled in? (check all that apply)

EnglishFrench ImmersionFrancophonePrivate School

What type of support do you need? (check all that apply)*

Please tell us more about your child including age, grade and any specific questions you have.*

What is your preferred method of communication with the peer support team? (check all that apply)*

EmailPhoneZoom

If you would like to be added to our mailing list, please check off which emails you would like to receive.*

Family Support program emailsDyslexia Canada monthly newsletterI don't want to subscribe to any emails at this time

Based on the information provided we will match you with a specific volunteer who can best provide support your family's needs. Typically we will respond within 3 business days. During busier times we may take a little longer.

If your question is urgent please email info@dyslexiacanada.org for faster response.

Family Support Intake Form