Hillside School Inquiry Form

Educational Concerns (Please check all that apply)

Difficulty with Abstract Concepts	Difficulty with Arithmetic
Difficulty with Expressive Language	Difficulty with Handwriting
Difficulty with Maintaining Attention	Difficulty with Math Fluency
Difficulty with Organization	Difficulty with Reading
Difficulty with Reading Fluency	Difficulty with Receptive Language
Difficulty with School Attendance	Difficulty with Spelling
Difficulty with Writing Fluency	Difficulty with Written Language

If your child has had educational or psychological testing done, please summarize the findings here:

Date of Evaluation