Dyslexia Checklist
Before we can set your child up for tutoring you will need to fill out this form. Please answer each question below.
Email address *
Phone number *
Your answer
Child's Name: *
Your answer
Parent/Guardian Name: *
Your answer
Child's Date of Birth: *
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YYYY
Child's Grade: *
Your answer
Child's School *
Has your child been tested for dyslexia? *
How did you hear about Therapy 4 Kids?
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