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Long Self-Test For Irlen Syndrome

  • 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:

  • Handwriting:

  • Attention/Concentration:

  • Copying:

  • Composition/Essay Writing:

  • Mathematics:

  • Music:

  • Depth Perception:

  • Sports Performance:

  • Driving:

  • Fatigue While In A Car: