Free Screener - Oct 29th 2nd thru 5th

DISCLAIMER: This is only a dyslexia screener which means it may show signs of dyslexia. It will not provide a formal diagnosis of dyslexia. If results of the screener show signs of dyslexia, we will recommend a full assessment. The screeners will be done in person at Nelms Dyslexia Center and should take approximately 15-20 minutes. Screeners will be given in groups of no more than 10 per group. Approximately a week after the screener, you will receive results via email with an opportuntity to schedule a phone consultation to discuss further.

Parent/Guardian Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent Email:

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Student Name

First NameLast Name

Student Date of Birth

Date

Student Age

Student Grade

Symptoms of dyslexia - please check all that apply:

Appointment

Free Dyslexia Screener - October 29th 2nd through 5th Grade

Parent & Student Information

Student History

Screener will be held on October 29, 2026.