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Reading Remediation Questionnaire  
Teacher Name  
School  
Student Name  
Grade  
   
For grades K-2:  
1. Approximately what reading level (according to the K-2 Assessment) is the student on?  
   
     

2. What high frequency words have not been mastered?

 
   
     
3. Are there any areas of phonemic awareness that are a problem?  
   
     
For grades 3-5:  

4. What level is this child reading on?

 
   
     
5. What books is she/he currently reading?  
   
     
6. What is the class currently reading?  
   
     
7. Please provide us with a list of novels/books the class will be reading this school year.  
   
     
8. Is it acceptable for the tutor to read ahead with this student?  
 

Yes

 
  No  
 
9. Do you assign book reports? If so, please give details of the assignments, how they will be graded and what the expectations are for the level of book that student may choose.  
   
 
     
10. Describe the student's comprehension. Please give details.
   
 
11. How does this student perform on comprehension activities?
   
 
12. Does the student read fluently? Please explain.
   
 
13. How does the student perform on spelling tests? What is the format of your spelling tests (i.e. where do the lists of words come from?)
   
 
14. What is the writing rubric that you use in your classroom? (Please provide us with a copy)
   
 
15. Describe the student's primary difficulties with writing.
   
 
Additional Comments