Click Confident

1. You and your child

Your nameYour email

Phone (optional)Child’s first name

Child’s ageGrade

Languages spoken at home What does your child love? Interests, pets, favourite things. I use these to make the app theirs.

2. Reading and spelling now

What worries you most about reading or spelling? Current T2R (Time2Read) level, if you know it You’ll find it on school reports or reading records. Reading scheme or books your child reads at school (e.g. Oxford Reading Tree level) What happens when your child gets stuck on a word?

3. School’s response

Has the teacher raised concerns about reading, spelling or language?

Yes No Not sure

What has school said or tried so far? Extra lessons, learning support, a remedial teacher, assessments. How has your child responded to that support?

Has your child had a formal assessment (educational, psychological, speech-language or occupational therapy)?

Yes No Not sure

If yes, who assessed and what did they find? You’re welcome to email reports separately.

4. Speech and language history

Did your child start talking later than other children?

Yes No Not sure

Has your child had speech-language therapy?

Yes No Not sure

Any history of frequent ear infections, grommets or hearing concerns?

Yes No Not sure

Does your child have difficulty with any of these? Tick any that apply.

Saying some sounds clearly Finding the right word Following instructions Telling a story or explaining Understanding what was read to them Rhyming or clapping syllables Remembering sequences (days, alphabet)

Anything else about speech or language?

5. Attention and learning

During homework or reading, my child usually… Tick any that apply.

How long can your child usually concentrate on a sit-down task? Anything else about attention, mood or confidence?

6. Family history

Has anyone in the family (parents, brothers or sisters, grandparents) had difficulty with reading or spelling?

Yes No Not sure

Has anyone in the family had speech or language difficulties?

Yes No Not sure

If yes, tell me a little more (optional)

7. Consent

I consent to Click Confident collecting and storing this information, including health and developmental information about my child, to plan their reading support. I understand it won’t be shared without my permission and that I can ask for it to be deleted at any time. Privacy policy

This form is not an assessment and doesn’t lead to a diagnosis. If anything suggests your child would benefit from a formal assessment, I’ll tell you and suggest who to see.

Parent intake form

1. You and your child

2. Reading and spelling now

3. School’s response

4. Speech and language history

5. Attention and learning

6. Family history

7. Consent