It is our pleasure to help improve your child’s learning abilities and to meet or exceed the goals youidentify at the conclusion of this questionnaire. Before we can design a solution unique to your child’s experience and learning style, we must determine what the root causes of learning and/or behavioral issues are.

This is the first of three steps on your journey to achieving the goals established by you. This questionnaire should be submitted at least two days before your child’s scheduled assessment, so our staff can evaluate your responses.

This questionnaire generally takes from 30 minutes to an hour to complete. Please be sure you have the time to complete the questionnaire before starting.

If you are disconnected before completing the form, your input data will be preserved for 2 days. When you reopen the form it will be populated with your answers. Thanks!

* The full price of the complete assessment (this questionnaire and the office visit) is $500.00 which is due at the time of your office visit. You c an save $25.00 off by using the prepay options at the end of the questionnaire.

Your information is safe with us. Meadowbrook Educational Services, Inc. does not share, sell, or convey by any means, information gathered by us, including this questionnaire without your written consent. Our complete Privacy Policy can be viewed here.