DISCOVERY Hero Checklist (8 to 12 years) Elementary

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DISCOVERY Hero Checklist (8 to 12 years) Elementary - Primaria

We want to know more about your Hero! The more we know about them, the better we may be able to serve them and your family.

Please answer one checklist per child. You can select more than one answers if needed on each question.

We appreciate your honesty. Please keep in mind, there are no right or wrong answers!

Please answer N/A on any questions that do not apply. Feel free to answer in either English or Spanish.

Email *

What is your full name? *

What is your Hero's full name? *

How old is your Hero? (specify years and months) *

What is their birth date? *

YYYY

Language Communication: What stage is your child at? *

Communicates in Spanish only

Communicates in English only

Communicates both in Spanish and English

Required

Language Comprehension: What stage is your child at? *

Has a difficulty comprehending in either Spanish or English

Comprehends in Spanish only

Comprehends in English only

Comprehends both in Spanish and English

Required

Reading: What stage is your child at? *

Reads fluidly in Spanish

Reads fluidly in English

Reads fluidly in both Spanish and English

Required

Writing: What stage is your child at? *

Writes sentences in Spanish

Writes paragraphs in Spanish

Writes short stories in Spanish

Writes sentences in English

Writes paragraphs in English

Writes short stories in English

Required

Has your child had any observations of any challenge in any of these areas by an expert/teacher/guide? *

Motor

Learning

Behavioral

Emotional

Other

None

Required

Please, tell us more: *

Please, tell us about your child's school history. What schools have they attended? Please provide school names and attendance period. *

Has your child been (or currently is) under specialized supervision/monitoring? *

Psychological

Academic

Visual (Dyslexia)

Auditive

Physical

Other

None

Required

Please, tell us more: (Name of therapist/specialist, name of center/school, reason and time period). If answer is no, mark N/A. *

Does your child has had any type of diagnostic? *

Yes

If so, what diagnostic? If answer is no, N/A. *

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