Dyslexia referral form 2025

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The document is a Dyslexia Referral Form designed for teachers to evaluate students suspected of having dyslexia. It includes sections for the teacher's assessment of the student's reading abilities, characteristics of dyslexia, and any relevant observations or risk factors. The form also requests information about family history of reading difficulties and requires submission of the student's written work to support the referral.

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Click ‘Get Form’ to open the dyslexia referral form in the editor.
Begin by entering the student’s name, ID number, and date at the top of the form. Ensure accuracy as this information is crucial for identification.
Fill in the student's date of birth, gender, grade, school, and teacher's name. This section helps contextualize the student's educational background.
In Section A, have the current or most recent classroom teacher complete the evaluation. They should assess the reader level and indicate which assessment was used along with its date and level.
Rate the student on various characteristics of dyslexia by circling 'Always', 'Sometimes', or 'Never' for each listed difficulty. This provides a clear picture of the student's challenges.
In Section B, document any at-risk factors that may affect academic performance. If there are none, leave it blank.
Indicate if there is a family history of reading difficulties by checking 'Yes' or 'No' and providing an explanation if applicable.
Finally, submit 3-4 dated examples of the student’s written work to support their eligibility for dyslexia assessment.

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What is the most common dyslexia?

Phonological Dyslexia It deals with difficulties in matching sounds to symbols and breaking down the sounds of language. Individuals with phonological dyslexia struggle to decode or sound out words. Its believed that phonological dyslexia is the most common type of dyslexia.

How do I know what type of dyslexia I have?

Reading specialists and psychologists can help identify the specific dyslexia challenges an individual has. No institution has created an official, diagnostic list of dyslexia subtypes, and some experts believe there arent types of dyslexia so much as a continuum or spectrum of various cognitive issues.

How do I get proof of dyslexia?

The only way dyslexia can be formally diagnosed is through a Diagnostic Assessment carried out by a certified dyslexia assessor. This assessment will tell you if your child is dyslexic or not.

How do you refer a child for dyslexia?

If youre concerned about your childs progress with reading and writing, first talk to their teacher. You may also want to meet with other staff in the school. If theres an ongoing concern, take your child to see a GP. It may be that your child has health problems that are affecting their ability to read or write.

How do I get an official diagnosis for dyslexia?

Neurologists and other medical professionals may also be qualified to provide a formal diagnosis. In the U.S., children who are having difficulties in school are legally entitled to request evaluation through their local school district.