Symptoms Survey

Looking for Alternative Treatments for ADD, ADHD and Autism?

Take our Free Symptoms Survey.

Vision Therapy is the treatment of choice to increase overall performance and improve learning and concentration skills that are often times linked to ADD, ADHD, Autism, and other learning disabilities.

Once you complete the form, someone from our office will be reaching out to you to go over your survey and answer any other questions you may have, to determine if an appointment should be made.

Our office will not reveal any of your personal information to anyone, or sell your information.

 

    1. Do you have headaches? *

    2. Fatigue with reading or comprehension drops with time? *

    3. Short attention span? *

    4. Difficulty keeping place while reading; use finger as marker? *

    5. Slow reading or word-by-word reading? *

    6. Skip or reread lines; omit words? *

    7. Reverses words or letters? *

    8. Difficulty remembering what has been read? *

    9. Difficulty copying from chalkboard or book? *

    10. Poor eye-hand coordination, including poor writing? *

      11. We respect your privacy. Your phone number and email is only used by Vision Development Center of Lancaster. Your information will never be used for any other purpose or used by 3rd parties. Your phone number is only used by Vision Development Center of Lancaster for the purposes of giving you the test results. Your information will never be used for any other purpose.

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