Sympton Survey Once you submit the survey, you will be able to view your results and a list of doctors in your area. Indicate below how often the following symptoms are experienced by you or your child: Headaches with near workNeverSeldomOccasionallyFrequentlyAlwaysWords run together while readingNeverSeldomOccasionallyFrequentlyAlwaysBurning, itchy, or watery eyesNeverSeldomOccasionallyFrequentlyAlwaysSkipping/repeating lines while readingNeverSeldomOccasionallyFrequentlyAlwaysTilting head or closing one eye when readingNeverSeldomOccasionallyFrequentlyAlwaysDifficulty copying from a chalkboardNeverSeldomOccasionallyFrequentlyAlwaysAvoiding near work or readingNeverSeldomOccasionallyFrequentlyAlwaysOmitting small words when readingNeverSeldomOccasionallyFrequentlyAlwaysWriting uphill or downhillNeverSeldomOccasionallyFrequentlyAlwaysMisaligning digits/columns of numbersNeverSeldomOccasionallyFrequentlyAlwaysPoor reading comprehensionNeverSeldomOccasionallyFrequentlyAlwaysHolding books or near work very close to eyesNeverSeldomOccasionallyFrequentlyAlwaysShort attention span with near workNeverSeldomOccasionallyFrequentlyAlwaysDifficulty completing assignments on timeNeverSeldomOccasionallyFrequentlyAlwaysSaying "I can't" before trying somethingNeverSeldomOccasionallyFrequentlyAlwaysClumsiness and knocking things overNeverSeldomOccasionallyFrequentlyAlwaysPoor use of timeNeverSeldomOccasionallyFrequentlyAlwaysLosing belongings or misplacing thingsNeverSeldomOccasionallyFrequentlyAlwaysForgetting thingsNeverSeldomOccasionallyFrequentlyAlwaysName First Last Email Your Score
