Linguaphile Skills Hub
Initial Information Gathering
* Required
Email address
*
Your email
Full Name of child
*
Your answer
Age of the child
*
Your answer
Full Name of Parent
*
Your answer
Address
*
Your answer
Phone number
*
Your answer
What type of Learning challenges does your child have?
*
Your answer
Has a Psyched assessment been completed?
*
Yes
No
Is your child attending school currently?
*
Yes
No
Are you exploring additional solutions for the child's learning needs?
*
Yes
No
Maybe
Are you exploring 1-2-1 home based or in classroom learning solutions?
*
1-2-1 Home based
Classroom
Not sure
Has any of the following been diagnosed for your child through a Psyched assessment (if completed)
*
ADHD
Autism
Dyslexia
Dyspraxia
Other
Required
By filling up this questionnaire you agree to Linguaphile Skills Hub retaining the data provided and get in touch with you through the contact details.
*
Agreed by parent
Required
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