SpeechAbilityLLC.com
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    • Dyslexia: Should My Child Be Evaluated?
    • Dyslexia Evaluation at SpeechAbility
    • My Child Has Dyslexia, What Do I Do?
    • Dyslexia and Reading and Writing (Literacy)
    • Spelling and Dyslexia
    • Effective Instruction with Students With Dyslexia
    • What is MultiSensory Structured Language Teaching?
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    • Milestones >
      • How Do I Know If My Child is Speech Delayed?
      • Phonology Processess
      • Sound Development Chart
      • By the End of Kindergarten
      • By the End of 1st Grade
      • By the End of 2nd Grade
      • By the End of 3rd Grade
      • By the End of 4th Grade
      • By the End of 5th Grade
      • Other Useful Parent Tips from ASHA
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    intake form FOR DYSLEXIA CONCERNS

    All information provided will remain confidential. Please fill out to the best of your ability. This information is needed in order to make official diagnosis.



    Mother's contact informaton

    father's contact information


    ACADEMIC CONCERNS

    Thank you for taking time to fill out this Intake form. These answers WIll help your child receive an individualized program specific to their needs.

Submit
Allison Winters
M.Ed., CCC-SLP. C-SLT
Shawnee, KS 66216
913-777-4SLP (4757)

SpeechAbilityLLC@gmail.com
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What Clients Say
“Allison has been a critical part in helping my daughter learn how to read more efficiently and she is now reading above her 5th grade-level. I am so thankful for all she has done for our family.” -Amy 
 
“Not only were we able to schedule an evaluation with Mrs. Winters within 3 weeks of initially calling, she answered all of my questions so we knew exactly what to expect on the day of testing. She also set aside time for a separate 2 hour meeting for my husband and me explaining all of Nathan’s results and gave us a plan to help him with his reading!” -Nicki N.

"Mrs. Winters helped me a lot with my reading. At first I didn't like having to go see her every week after school but now I don't mind at all because I can read!" -Luke Z.