Read With Kourtni
Unlocking Potential, One Sound at a Time
Reading Concern Documentation Template
Use this worksheet to organize specific examples of your child's reading and spelling concerns before communicating with the school.
Student Information
Student name
Grade
School
Date completed
Concerns I Have Observed
Check the areas you have noticed. Focus on specific patterns and examples rather than trying to determine a diagnosis.
Specific Examples
Describe specific words, assignments, homework situations, or reading behaviors you have observed.
When Do These Difficulties Occur?
Note whether concerns occur during homework, independent reading, spelling, tests, oral reading, or other situations.
What Has the School Shared?
Record teacher comments, reading scores, intervention information, progress reports, or concerns discussed by school staff.
Supports or Interventions Already Tried
List tutoring, intervention, classroom supports, accommodations, home practice, or other strategies already attempted.
Questions I Want Answered
Write the questions you want to bring to your teacher, campus administrator, reading specialist, ARD/IEP team, or Section 504 team.
RWK Parent Tip
Bring specific examples whenever possible. Dates, work samples, teacher communication, progress data, and patterns observed over time can make school conversations more productive.