Please list the information about your children:

First Name (or anonymous):

Age: Years Homeschooled? Grade:

Is this the grade they should be according to public school aging? If not, please describe the
reasoning.

Please describe any instances when the child was taught by someone else (other than co-op
classes) including intervention or professional services:

Reading level of known:

Do you feel your child is Above/Behind/On reading level for their age/grade?

How did you determine this?

Have they ever been tested by a professional for reading delay or other learning
difficulties (please describe):

How many hours a day, on average, does your student read for school?
For fun (including book on tape, or being read to)?

Does your child have any special educational needs please describe (suspected or diagnosed)?

If you feel comfortable please describe why you homeschool:

Would you be interested in your child receiving any evaluations from me to determine reading
levels?

In your opinion, how do homeschool/nontraditional school parents determine if their children are
on reading level?

If your child is behind or you suspect they are behind, how do you determine the best way to
approach getting them caught up?

What resources are available to homeschool teachers? What organizations or professionals do

you rely on to help determine educational plans for children with disabilities?

What support do you need most, at this time, to teach reading and literacy to your children?
Please add any other information that you think is important for me to know about your
student(s).