Jumpstart Learning Lab @ Oasis Place 
Thank you for showing interest in this program. This program is designed to support individuals with specific learning disorders, including dyslexia, reading and writing challenges. Help us understand your needs better by completing the form below.

Kindly note that we will be contacting you for a simple screening before placing your child. Registration will be confirmed only upon receipt of your registration fee. - Oasis Place
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Child's FULL NAME as in NRIC/Passport *
Child's Date of Birth *
Date
Child's Gender *
Does your child have any learning challenges (e.g., dyslexia, reading, writing, etc.) or neurodevelopmental (e.g., ASD, ADHD, etc.) diagnosis, if any?
Parent's Full Name *
Parent's Contact Number.  *
Parent's Email Address *
Name of School *
School Level (Grade/Year/Standard) *
Is your child receiving any learning intervention (e.g., at school, therapy, specialised tutoring, etc.)? If yes, please specify.  *
Please provide a contact (e.g., class teacher, tutor, learning support, therapist, etc.) for us to collaborate and share strategies, supporting your child's needs effectively. *
Have you/your family used any of the screening tools  (Autism, ADHD, Dyslexia, Social Communication challenge, Mental Health) available on our website? (https://oasisplace.com.my/screening-test/)
Dyslexia frequently co-occurs within families;studies show that the heritability of dyslexia is estimated to be around 40–60% (Source Front. Psychol.)
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Please select the program you are interested in: *
Please select the type of package you are interested in.
*Packages are inclusive of assessment and report. 
Fees are applicable for Residents (Malaysians with valid IC/Passport and expatriates with a Malaysian address). For clients on short-term visits or without a valid Malaysian address, international fees apply – please contact us for details.  
*
Is your child able to attend to tabletop tasks (e.g. writing and reading)? *
Please select answers for the following questions regarding your child's verbal competency:  *
No
Sometimes
Yes
My child is able to speak in complete sentences.
My child is able to respond appropriately to simple instructions.
My child is able to express their needs and feelings verbally.
My child is able to ask questions to seek information or understanding.
My child uses appropriate vocabulary for his/her age.
Kindly share any relevant details that can aid the interventionist in tailoring sessions for optimal child success. This may include visual schedules, brief breaks every 15 minutes, or behavior management tactics. *
Please suggest some ways to help your child to calm down if he or she is upset or becomes disregulated. *
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