Form for Employers

Your perspective as an Employer is very helpful for the assessment process. Everything you include will be treated confidentially and only used for forming a more complete picture of the individual being assessed. Please do not complete this before you have been in contact to arrange an assessment.

Use a coloured overlay!

Manager’s Name Position Company Phone Email Employee Name Date Completed Signed

General Information

Please provide a brief description of the individual’s job, their priorities, and any particular key performance criteria.

What are the individual’s key strengths as highlighted in a recent appraisal? What difficulties do you think dyslexia is posing for them at work?

Observed Challenges

Dyslexia generates different strengths and weaknesses for every individual. Please indicate where challenges arise within the workplace.

Reading

Following written instructions

No difficulty Minor Moderate Considerable

Following technical manuals

No difficulty Minor Moderate Considerable

Quickly getting the gist of documents

No difficulty Minor Moderate Considerable

Detailed comprehension at speed

No difficulty Minor Moderate Considerable

Recalling what has been read

No difficulty Minor Moderate Considerable

Writing Tasks

Spelling

No difficulty Minor Moderate Considerable

Handwriting

No difficulty Minor Moderate Considerable

Expressing ideas in writing

No difficulty Minor Moderate Considerable

Writing memos, emails and letters

No difficulty Minor Moderate Considerable

Drafting complex material quickly

No difficulty Minor Moderate Considerable

Writing reports

No difficulty Minor Moderate Considerable

Organisation

Planning work schedule

No difficulty Minor Moderate Considerable

Meeting deadlines

No difficulty Minor Moderate Considerable

Keeping papers in order

No difficulty Minor Moderate Considerable

Working efficiently

No difficulty Minor Moderate Considerable

Memory and concentration

Following oral instructions

No difficulty Minor Moderate Considerable

Remembering messages / appointments

No difficulty Minor Moderate Considerable

Concentrating for long periods

No difficulty Minor Moderate Considerable

Speech and comprehension

Following a conversation

No difficulty Minor Moderate Considerable

Contributing to a discussion

No difficulty Minor Moderate Considerable

Presenting thoughts succinctly

No difficulty Minor Moderate Considerable

Mathematical skills

Copying numbers

No difficulty Minor Moderate Considerable

Tabulating numbers

No difficulty Minor Moderate Considerable

Doing arithmetic calculations

No difficulty Minor Moderate Considerable

Following a sequence/procedure

No difficulty Minor Moderate Considerable

Checking data

No difficulty Minor Moderate Considerable

Visual and motor skills

Inputting data on a computer/calculator

No difficulty Minor Moderate Considerable

Analysing complex visuals e.g. maps, graphs, tables of figures

No difficulty Minor Moderate Considerable

Getting bearings in large or complex buildings

No difficulty Minor Moderate Considerable

Sequencing

Filing

No difficulty Minor Moderate Considerable

Retrieving files

No difficulty Minor Moderate Considerable

Looking up entries in dictionaries/directories

No difficulty Minor Moderate Considerable

Further Information

Please provide any further information which you feel may be relevant.