You may have been asked to complete our Learning Behavior Questionnaire concerning your student’s learning skills. This form is a series of questions that yield a score to identify areas of concern. Your score and the answers to the questions will be kept in the strictest confidence.

Once you have completed the form, click Send, and upon receiving the Learning Behavior Questionnaire we will review the answers and email the results to you.  There is no obligation of any kind to get these results. We will send you the results of the questionnaire and a letter with basic information about our services. You will not receive any further solicitations from this submission.

We never sell, share or trade your information with anyone.

Some of the typical questions we ask in our Learning Behavior Questionnaire are …

Have you and your child been hearing any of the these messages at teacher conferences where you are told that your student is …

  • “reading below grade level”
  • “performing below expectations”
  • “can’t stay on task”
  • “distracts easily”
  • “won’t follow instructions”

We also ask questions such as …

  • Does your student spend way too much time on homework?
  • Does your student read below grade level?
  • Is your student a slow and inaccurate reader?
  • Is your student a poor speller?

The answers to the questions will give us a first glimpse of your student and help us determine your student’s needs and a program to recommend, if one is needed. We want to emphasize that our programs are interventions, not life-long commitments. Our programs are specific, research based, intensive, one-on-one Academic Therapy that help an individual overcome their learning problems.

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Please read each of the following statements and rate your student by selecting a number from 0 to 4 for each statement. Be sure to complete all the items.

When you have completed the Questionnaire select the submit button at the bottom .


COMPARED TO OTHER STUDENTS THE SAME AGE...

0 - Occurs less often OR the question doesn't apply
1 - Occurs at about the same frequency
2 - Occurs slightly more
3 - Occurs considerably more
4 - Occurs very considerably more



COMPARED TO OTHER STUDENTS THE SAME AGE...

0 - Occurs less often OR the question doesn't apply
1 - Occurs at about the same frequency
2 - Occurs slightly more
3 - Occurs considerably more
4 - Occurs very considerably more



COMPARED TO OTHER STUDENTS THE SAME AGE...

0 - Occurs less often OR the question doesn't apply
1 - Occurs at about the same frequency
2 - Occurs slightly more
3 - Occurs considerably more
4 - Occurs very considerably more



Whew... That was a long form.

We respect your privacy, and will not share your information with anyone.