Reading Strategies Assessment Questionnaire Form
Complete this questionnaire to assess reading habits, strategy use, and confidence with different types of reading.
Reading Profile
Grade or Age Range
*
Kindergarten
Grades 1-2
Grades 3-5
Grades 6-8
Grades 9-12
College/University
Adult Learner
Prefer not to say
How Often Do You Read?
*
Daily
A few times a week
Once a week
A few times a month
Rarely
Typical Reading Formats Used
*
Books
Articles
Textbooks
Digital Articles
Ebooks
Other
Average Reading Time per Session
Less than 15 minutes
15-30 minutes
31-60 minutes
1-2 hours
More than 2 hours
Comprehension and Confidence
Overall reading comprehension confidence
*
1
2
3
4
5
Confidence when reading dense or academic text
*
Not at all confident
1
2
3
4
5
6
7
8
9
Very confident
10
1 is Not at all confident, 10 is Very confident
Biggest reading challenge / area for improvement
Please Select
Main idea and details
Vocabulary in context
Long passages
Making inferences
Summarizing
Reading speed
Staying focused
Other
Goals and Support Needs
Primary reading goal
*
Please Select
Improve speed
Improve comprehension
Increase vocabulary
Read more consistently
Prepare for an exam or class
Other
Preferred support or resources
One-on-one tutoring
Reading strategies handout
Guided practice exercises
Audio or narrated materials
Vocabulary lists
Comprehension questions
Study group
Regular check-ins
Other
Submit
Should be Empty: