Dyslexia Tutoring Program

711 West 40th Street, Suite 310

Baltimore, MD 21211

PHONE 410-889-5487     FAX 410-889-5363

Client Report Form

Client    _________________________________  Month/Year   ________________

Tutor     _________________________________

Attendance

Date of Session                                    Duration                                 Location 

_______________                              ____________                     _______________

_______________                              ____________                     _______________

_______________                              ____________                     _______________

_______________                              ____________                     _______________

_______________                              ____________                     _______________

                            Total Hours   ____________

Skills Taught / Practiced:

__alphabet sequence      __consonant sounds                 __blends

__short vowels               __long vowels                          __vowel teams

__syllable types              __syllable division rules           __spelling rules

__suffixes/ prefixes         __handwriting

__other concepts or skills

General Observations: (use back if necessary)

CHECK HERE IF YOU WOULD LIKE TO SCHEDULE A TUTOR OBSERVATION.

Please use 1 sheet for each month.

We need to learn some of the skills you are working on with your student. Please note, this is not a lesson plan, nor does it represent a sequence you should be following. Students vary in skills, needs and speed of learning. The beauty of individual tutoring is the ability to tailor the lesson to the student.

Signature: ____________________________   Date: _________________