VirtuaStudy Club — Complimentary Reading Skills Assessment
VirtuaStudy Club — K–5 Online Academic Support. Share your child’s reading snapshot and availability so we can recommend the right K–5 group and schedule your complimentary assessment.
Parent / Guardian Information
Parent / Guardian Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Email
Text
Either
Family Time Zone
*
Please Select
Eastern
Central
Mountain
Pacific
Alaska
Hawaii
Other
Student Information
Child’s Full Name
*
First Name
Last Name
Child’s Current Grade
*
Kindergarten
1st
2nd
3rd
4th
5th
Child’s Age
*
Has your child previously received reading tutoring or intervention?
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Yes
No
If yes, briefly describe the type of support and how recently it occurred
Reading Snapshot
How does your child usually feel about reading?
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Loves it
Usually enjoys it
Neutral
Often frustrated
Avoids reading
Not sure
What concerns you most about your child's reading right now?
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Recognizing letters/sounds
Blending sounds into words
Sounding out unfamiliar words
Reading common/high-frequency words
Reading smoothly/fluently
Reading too slowly
Understanding what was read
Vocabulary
Remembering details
Answering questions about a text
Confidence/frustration
School grades/teacher concerns
Other
Please describe what you are seeing at home when your child reads.
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Does your child tend to guess words from pictures or context instead of sounding them out?
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Often
Sometimes
Rarely
Not sure
Does your child have difficulty reading unfamiliar or made-up words?
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Yes
No
Not sure
Does your child read aloud smoothly, with appropriate phrasing and expression?
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Usually
Sometimes
Rarely
Not sure
After reading a short passage, can your child explain the main idea or important details?
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Usually
Sometimes
Rarely
Not sure
Has your child's teacher or school expressed a concern about reading?
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Yes
No
Not sure
What has the teacher or school shared?
Has your child had any recent reading assessment, school reading support, or related learning plan that you would like us to be aware of?
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Yes
No
Not sure
Please briefly summarize what you know.
Goals
What would you most like your child to improve?
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Phonics / decoding
Fluency
Reading comprehension
Vocabulary
Confidence
School performance
Independent reading
Not sure — I want the assessment to guide us
If VirtuaStudy is successful for your child, what change would you hope to notice over the next few months?
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Availability
Which days generally work for recurring online sessions?
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Monday
Tuesday
Wednesday
Thursday
Friday
What time windows generally work?
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3:00–4:00 PM
4:00–5:00 PM
5:00–6:00 PM
6:00–7:00 PM
7:00–8:00 PM
Other
Are you generally looking for twice-weekly recurring reading support?
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Yes
No
Not sure
Earliest preferred start date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
VirtuaStudy Club — Complimentary Reading Skills Assessment
VirtuaStudy Club helps identify your child’s current reading skill profile and recommend an appropriate instructional group. It is an educational placement assessment and is not a clinical or diagnostic evaluation.
How soon would you like to schedule the complimentary assessment?
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As soon as possible
Within 1 week
Within 2 weeks
Just gathering information
I understand that this is an educational reading placement assessment, not a medical or clinical diagnosis.
*
I understand that this is an educational reading placement assessment, not a medical or clinical diagnosis.
Final Notes
Is there anything else you would like VirtuaStudy to know about your child as a reader?
How did you hear about VirtuaStudy Club?
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Website
Referral
Facebook
Instagram
School/Teacher
Community
Other
Thank you! We’ve received your VirtuaStudy Reading Skills Assessment request. We’ll review your information and contact you with the next step for scheduling your child’s complimentary assessment.
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