Thank you for your interest in the programs at The Reading Lab.

SUMMER CAMP:  Our 2012 Summer Camp Sessions are completely full and we can no longer accept
enrollment applications.

FALL AFTER SCHOOL SESSIONS: We are currently accepting enrollment applications for fall sessions.

For your convenience, you may schedule a PARENT ORIENTATION SESSION by requesting a meeting with
your comments below. This meeting is to give you more details, an opportunity to ask questions, to visit the
Lab, and to discuss the various pricing options.

Did you know that the cost of your child's tuition may be tax deductible as a medical expense?
According to IRS Publication 502, if your child's doctor recommends special tutoring or training by a qualified
provider, the cost of tuition is tax deductible. Consult IRS Publication 502 (Medical and Dental Expenses) for
the current tax year for details.

In order for us to prepare for your special visit, or to receive additional information
about The Reading Lab, please complete the form below. Thanks!

Please use the form below to learn about our nationally recognized and scientifically validated services. A
confirmation will be sent to your email address.
Your full name:
Street Address
City
State
Zip Code
Your phone number:
Your email address:
Confirm email address:
Name of child
Current or most recent grade level
Age
Date of Birth
00/00/0000
This short questionnaire will help us understand your child's learning and/or reading
abilities. All sections must be completed fully.

In the first section, please choose the answer that most represents your child.
    1. Strongly Agree
    2. Agree
    3. Neutral
    4. Disagree or does not apply at this age

Compared to other children of the same age and gender, my child:
1. Finds decoding new words difficult:
2. Struggles with comprehension:
3. Difficulty remembering things:
4. Dislikes or resists reading:
5. Has or has had speech or language delays:
6. Takes a long time with homework or school assignments:
In this next section, please answer each prompt before submission.

Briefly describe your child's reading problem below:
What testing, diagnoses, or special services has your
child received now or in the past?
And, finally, how did you hear about our clinic?
When the form is complete, please click the "Submit" button below. To make changes
before you submit your information, click the "Reset" button, make any necessary
changes, then press the Submit button.  NOTE: In the rare instance that your
computer will not send this form, you may have to temporarily disable your
virus/firewall security to allow this submission. Thank you.
SPECIAL NOTE:  If you submit
this request during our
SUMMER or WINTER
INTERSESSION BREAK,
we will reply when we return to
the Lab. Thanks again!
Enter starting street address:

City, State or Zipcode:
The Reading Lab
Arbor Square Office Park
17000 El Camino Real
Suite 104-B
Houston, TX 77058
281-480-READ
For More Information
The Reading Lab:
Optimising learning through neuroscience...