Catherine Warner
25, avenue du Mail
1205 Geneva, Switzerland
(022) 321 70 42
 e-mail      www.dyslexia.com      FRENCH  


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Name of the dyslexic person:

Date of birth:

Is this for: yourself       your child       other

Grade level in school (children) /Present employment (adults):


What are the aspects of dyslexia that are involved in this case?

Reading:   Difficulty reading out loud        Poor comprehension

Poor retention        Other


Writing:  Poor spelling       Poor handwriting


Math:   Lacks confidence in basic number facts (addition, subtraction, multiplication)

Can’t understand what to do in a word problem

Finds the answer but can’t explain how


Your phone number: (optional)


  

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