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This
checklist is not designed to take account of the gifts and talents commonly
associated with dyslexia.
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We are currently developing a more accurate adult dyslexia checklist. You can help us (1) copying and circulating this checklist so we can reach as many people as possible and (2) completing the checklist yourself, filling in the details requested below. We welcome any comments in the box at the bottom of the page. Please return to us at ADO, 336 Brixton Rd, London SW9 7AA Many thanks for your contribution to our research |
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Tick and complete the following: 1. I am diagnosed as dyslexic 2. I think I am dyslexic 3. I am not dyslexic 4.Male Female 5. Left-handed Right-handed Ambidextrous 6. Date of birth: __/__/____ |
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Name:___________________________________ Address:__________________________________ _______________________________________ ______________________Post code:__________ All information will be treated confidentially. |
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| PLEASE WRITE ANY COMMENTS / SUGGESTIONS HERE | |
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Please send form to the above address
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