Academic and Diagnostic Testing: Orton Gillingham Institute
Thank you for your interest in The Orton Gillingham Institute! By completing this form, you are beginning the process of academic testing, psychoeducational testing or both. Upon completion of this form an invoice will be created and sent to the email address listed. Please double check your contact information to ensure that it has been entered correctly. Once this form is submitted you should expect an automatic confirmation via email which will provide you with further details on what to expect, and how to confirm training dates. If you have any questions please email us at: support@ortongillinghaminstitute.com or Call us at: 917-563-2022. You may also visit our webiste at www.ortongillinghaminstitute.com. We're excited to be working with you.
Your Full Name
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First Name
Last Name
Your Email Address
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Your Home Address
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Street Address
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City
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Your Phone Number
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Please enter a valid phone number.
How many children would you like to test?
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Please list the number of children you would like to have tested. Your invoice will reflect the type of tests you have chosen and the number of testers.
What is/are the names and dates of birth of the child(ren) you would like to test?
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Please add the full First name and Last name and Date of Birth. Example: John Smith- 01/01/2001
What type of testing are you interested in?
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Please Select
Academic Testing
Psycho-Educational Testing
Combined Academic & Psycho-Educational Testing
What School Does Your Child Attend?
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Please add the name of the school your child attends.
What Grade Is Your Child In?
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Please list the grade your child is currently in.
Does Your Child Have an IEP?
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Yes, My Child Has an IEP
No, My Child Does Not Have an IEP
What School Does Your Child Attend?
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Is Your Child Currently in Special Education Classes?
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Please Select
Yes
No
Hybrid
Has Your Child Received a Diagnosis?
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Please Select
Yes
No
What Has Your Child Been Diagnosed With?
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Do you have any questions or considerations you want to add? If yes, please write them below.
Please provide as much detail as possible. If you have any specific concerns, or tests you would like us to administer, please add them here.
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