Warning Signs Checklist

Warning Signs Checklist
Are you or your child (or your student) struggling to learn?

Does it affect life at home, at school or at work?

Take 5 minutes to complete the Warning Signs Checklist and discover whether you or your child could have learning difficulties that are impacting your lives, and what to do about it.
Your Name (for PDF)
Their Name (for PDF)
Their Age Group (for PDF)
Email (for PDF)
Are you looking for help for yourself or someone else (for example your child)?*

My ChildMy StudentMyself
What age group are they in?*
What is their gender?*
Are You A Teacher?

If you are filling out this form for a student please use the

Teacher's Warning Sign Checklist.

Thank you for completing the Warning Signs Checklist.

Please fill out the information below so we can send you your results.
Your First Name*
Their First Name*
E-mail*
Unique Submission ID
Myself vs Someone Else Tolken for Infusionsoft
Student vs Adult Tolken for Infusionsoft
Should be Empty: