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* 1. Please provide your first and last name.

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* 2. Please provide your child's name, age and grade.

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* 3. Where does your child currently attend school?

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* 4. What specific reading challenges does your child currently face (e.g., difficulty decoding, comprehension, fluency, etc.)?

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* 5. Has your child been previously diagnosed with dyslexia, ADHD and/or other learning differences? If yes, please provide details.

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* 6. What has been your child's experience with reading at home and school (e.g., frustration, avoidance, enjoyment)?

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* 7. Has your child received any previous reading intervention or support services (in school intervention, IEP services, private tutoring)? If so, what were the results?

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* 8. What are your goals for your child's reading progress (e.g., improve reading confidence, achieve grade-level proficiency etc.)?

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