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Irlen Self Assessment

Do you experience any of the following?

Please fill out this self test form and Stephanie will contact you with your results.

Please let us know your name.
Please let us know your email address.
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READING, WRITING, COPYING: Skip words or lines?
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Misreads words?
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Avoids or makes errors?
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Reads slowly
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Loses place?
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Rereads for comprehension?
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Takes breaks?
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PHYSICAL SYMPTOMS: Strain or fatigue?
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Tired or sleepy?
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Head hurts or headaches?
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Eyes hurt, burn, dry, itchy?
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Fidgety or restless?
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ENVIRONMENTAL CHALLENGES: Light Sensitivity?
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Depth perception?
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Clumsy?
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Tracking moving objects?
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Night driving?
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Glare?
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Computers, iPads, smartphones?
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