Read With Kourtni
Unlocking Potential, One Sound at a Time
Written Evaluation Request Template
Use this parent-friendly template to organize your concerns and prepare a written request to discuss a comprehensive evaluation with your child's school.
Parent and Student Information
Parent / caregiver name
Date
Student name
Grade
School / campus
Teacher or school contact
Written Request
Dear School Administrator or Educational Team,
I am writing because I have concerns about my child's reading and/or spelling development. I would like to discuss whether a comprehensive evaluation is appropriate and what next steps are available based on my child's current needs and educational data.
My concerns include:
Supports, interventions, or services that have already been tried include:
I am providing or referencing the following information:
Please provide information about the appropriate next steps, any additional information needed from me, and applicable procedures or timelines.
Thank you for working with me to better understand and support my child's reading needs.
Parent Signature and Contact Information
Parent / caregiver signature
Date submitted
Phone
RWK Parent Tip
Keep a dated copy of your written request and any documents you submit. Save emails, letters, meeting notes, assessment results, intervention records, and written responses from the school together for your records.