Free Reading Screening: Stamford Ferguson Library
1:00 pm ‒ 1:30 pm on April 25, 2026
1 Public Library Plaza, Stamford, CT 06901
Reading Screening Registration
Thank you for participating in the free reading screening with The Windward Institute made possible by the Early Literacy Endowment.
This screening is provided for free and is voluntary. Your child will participate in screening of early language and literacy skills by a trained school-based professional, aimed to identify potential reading risks. Screening does not diagnose dyslexia or identify a disability. The Windward Institute staff are not healthcare providers or licensed psychologists, so screening should not replace a formal evaluation as part of the eligibility process for special Education.
All information on the form provided on this form will be kept confidential. All information will be used anonymously for research purposes but will never be shared directly with other organizations and institutions.
Parent/Guardian First Name
(Required)
Parent/Guardian Last Name
(Required)
Phone
(Required)
Email
(Required)
Child's Name
(Required)
Child's Current Grade
(Required)
Child's Current School
(Required)
Language spoken at home
(Required)
Language spoken at school
(Required)
This field is hidden when viewing the form
NYPL Disclaimer
DISCLAIMER: Dyslexia screening is being provided to you and/or your minor child(ren) free of charge by The Windward Institute, a third-party service provider outside the control of The New York Public Library (the “Library”). You acknowledge and agree that participation in this dyslexia screening is purely voluntary and that you will not receive any compensation or benefit from the Library for your and/or your minor child(ren)’s participation.
The Library has opted to provide this opportunity for our patrons to have access to free dyslexia screening (the “Services”). You may elect to speak with a healthcare professional if you have questions or concerns about the Services or any course of action recommended by the provider of the Services. The Library is not a healthcare provider and does not endorse any service provider or the products or services they provide.
The Library is not responsible for (i) the reliability or accuracy of the Services, or (ii) the security or privacy of any information you provide to The Windward Institute.
STATEMENT OF CONSENT AND PRIVACY
I, the parent, legal guardian, or custodian of the student named on this form, give consent for The Windward Institute to administer the DIBELS-8 and CUBED-3 to my child. I have read all the information above, and I acknowledge that the data may be used anonymously for research purposes but will never be shared directly with other organizations and institutions.
Signature
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