Please fill out this form. Parents, complete the form in cooperation with your child.
NOTE: YOUR EXPERIENCES CAN BE IN THE PAST,
WHEN IN SCHOOL, AS WELL AS THE PRESENT.
Are you light sensitive?
Types of reading difficulties:
While reading or using a computer, do you:
Do you feel strain, fatigue, tired, or have headaches when:
Fatigue While In A Car:
Developed By: TinyFrog