Children's Literacy Assessment Request Form

Help Your Child Develop Strong Reading Skills

If you're concerned about your child's reading development, our library's literacy assessment program is here to help. This Children's Literacy Assessment Request Form makes it easy for parents and caregivers to connect with our specialized literacy services and intervention programs designed to support young readers.

Why Use This Library Literacy Assessment Form?

Reading proficiency is foundational to academic success, and early identification of literacy challenges can make a significant difference in a child's educational journey. This form template allows libraries to:

• Gather comprehensive information about each child's reading abilities, challenges, and learning environment
• Identify specific areas of concern such as phonics, comprehension, fluency, or vocabulary
• Match families with appropriate intervention programs based on grade level and assessed needs
• Create a seamless referral process that connects parents with reading specialists and tutors
• Track and manage assessment requests efficiently through your library's existing workflows

Designed for Educational Support Staff and Families

This template is optimized for public libraries, school libraries, and community literacy programs that serve families with children from preschool through elementary school. The form collects essential information including current grade level, specific reading concerns, home reading habits, and previous interventions or support services.

With Paperform's conditional logic, you can customize which questions appear based on the child's age or grade level, ensuring parents only answer relevant questions. The clean, accessible design makes it easy for families from all backgrounds to request support.

Streamline Your Literacy Program Management

Once a parent submits an assessment request, you can use Stepper to automatically route the submission to the appropriate literacy coordinator, schedule follow-up appointments, send confirmation emails with next steps, and create records in your library management system. This automation ensures no child falls through the cracks and families receive timely responses.

Whether you're a children's librarian, literacy coordinator, or education program manager, this template provides a professional, welcoming way to help families access the reading support their children need to thrive.