SPELD NSW Assessment Booking SPELD NSW Assessment Booking Form Thank you for your interest in booking an assessment with SPELD NSW. Please complete this form if you would like to book an assessment with SPELD NSW.Information About the Person Being Assessed Name of person being assessed(Required) Date of Birth of person being assessed(Required) Day Month Year Age of person being assessed Contact DetailsName of person making the assessment booking(Required) Relationship to person being assessed(Required)ParentGrandparentCarerBooking for myselfPhone(Required)Email(Required) Address(Required) Reason for Assessment BookingWhy are you interested in booking an assessment? What concerns do you have about your or your child's literacy or numeracy?(Required)Previous AssessmentsHas the person being assessed undertaken any previous assessments?(Required) Cognitive Testing with School Counsellor or Psychologist Academic Testing in Literacy or Numeracy (in addition to classroom assessments) Speech & Language Assessment Occupational Therapist Assessment Assessment for ADHD by a paediatrician or psychologist Assessment for Autism Spectrum Disorder No prior assessments What was the result of these assessments?InterventionHas the person being assessed received at least 6 months targeted intervention in any of these areas?(Required) Reading Spelling Written Expression (clarity or organisation of written expression, grammar, and punctuation) Mathematics Handwriting (mechanical aspects of handwriting) No targeted intervention Please note that before a diagnosis of a specific learning disorder can be made, it is essential that a child being assessed has received at least six months of intervention focused on improving their skills in their academic area of difficulty. These six months of intervention can include targeted instruction from a specialist tutor or allied health professional, in-school intervention by a learning support teacher in small groups or one-on-one, and (in some circumstances) a parent at home.Assessment BookingFor more information on the different assessment types please see our website.Which assessment would you like to book?(Required) Psycho-educational Assessment of Numeracy Psycho-educational Assessment of Literacy Psycho-educational Assessment of Literacy and Numeracy Educational Assessment of Numeracy Educational Assessment of Literacy Educational Assessment of Literacy and Numeracy Diagnostic review (for previous SPELD NSW Clinic Clients only) Would you like an Attention Deficit Hyperactivity Disorder (ADHD) assessment added to your Psycho-educational Assessment? Yes No Location of Testing(Required) Face to face Online Please note that Online Assessment is only available to clients in regional and rural areas and clients in Sydney who have a disability or illness that makes it difficult to attend the SPELD NSW Office.Other notes or queries for the SPELD NSW ClinicNext Steps in the Booking Process After you submit this form, SPELD NSW Clinic will then send you an email with some forms for you, your child's teacher, and any tutors to complete and we will ask you to return the completed forms plus some additional paperwork (including school reports). Once we receive the completed paperwork, we will contact you to book a date for the assessment. CAPTCHANameThis field is for validation purposes and should be left unchanged.
