1. Download and print the first three sections of the Referral Packet below.
    • High school seniors must also download section 4.
    • Refer to checklist for items not included in download that you must provide
  2. Fill out Referral Packet completely.
    • Refer to checklist explanations in Section 1 if you are not clear about certain items.
  3. Return completed Packet to:

                    Tasha Falkingham
                    Regents' Center for Learning Disorders
                    331 Milledge Hall
                    Athens, GA 30602-5875

Please note: Incomplete Referral Packets will result in a delay in scheduling.


Download Section 1

Section 1 includes the informational letter, the referral packet checklist, the explanation of checklist items, the RCLD refund policy, and the release of information.

Download Section 2

Section 2 includes the case history.

Download Section 3

Section 3 includes the credit card agreement form, several behavioral rating scales, and the Adult Reading History Questionnaire.

Download Section 4

Section 4 is only required if the student is still in high school. Section 4 includes the high school informational letter, the high school referral packet checklist, the high school explanation of checklist items, the RCLD refund policy, and the high school release of information.




Students' Link Disability Service Providers Evaluators Faculty