Has your child shown interest in reading?
Yes, very interested Somewhat interested Not interested yet Not sure
How often do you read with your child?
Daily Several times a week Once a week Rarely
Does your child struggle with any specific reading skills?
Phonics Comprehension Fluency Vocabulary Not sure
Have you considered seeking help for your child's reading struggles?
Yes No
What age group does your child belong to?
3-5 years 6-8 years 9-11 years 12-14 years 14+ years
What type of books does your child enjoy?
Adventure Mystery Fantasy Non-fiction Graphic novels
All set, how can we reach you?
Name
Email
Phone
(Details here)
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