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Dyslexia Records Request Form
Parents: Please complete this form if you would like a copy of your child's Dyslexia report.
Students: If you are 18 years or older, you may request records for yourself.
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DATE:
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MM
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DD
/
YYYY
Student Name:
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Your answer
Student current campus:
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Your answer
Name of Person making request:
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Your answer
Email address:
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Your answer
Contact number:
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Your answer
Please choose one:
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I am requesting a copy of my Dyslexia records
I am requesting copies of my child's Dyslexia records
How would you like the records:
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Pick up at the Admin SpEd Office: 600 S. Bois d'Arc Street, Forney, TX 75126.
I consent to receiving my records electronically to my email address.
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