LSR7 Parents as Teachers

7/21/21 DIAL-4 Developmental Screening Request

This form is used to schedule your child for a FREE Developmental Screening through the Lee's Summit R-7 Parents as Teachers Program. Please note...this screening is NOT intended for children starting Kindergarten August 2021.

It is very important for you to complete the information requested in its entirety.  A time slot is equal to one screening appointment per child.  If you are scheduling for more than one child, please create more than one time slot (appointment).

Eligibility Requirements:

  • Child must be at least 3 years of age and not currently eligible for kindergarten.
  • You must live within the Lee's Summit R-7 School District boundaries. Click here to verify.
  • Only one adult per child will be permitted in the building for a screening appointment.  Please allow and be available for a duration of approximately 1.5 - 2 hours to complete the screening. No siblings are permitted.
  • You must provide proof of residency via an electric, water or gas utility bill dated within the last 30 days.

Please note:  A completed Enrollment Form and Health History Form for your child is also required prior to arriving for your screening appointment.  You will receive an email approximately 2 weeks in advance of your screening appointment with directions and links for submission of these forms.  Forms must be received within 24 hours of your screening appointment.

Please call 816-986-2486 with any questions or to cancel/reschedule a screening appointment. You may also cancel by editing/deleting your already scheduled time slot on this Sign Up Genius.  You will need to reschedule your appointment if you or your child are feeling unwell.

Due to health and safety guidelines, you and your child will be provided hand sanitizer upon entry to the building.

Thank you!  We look forward to seeing you and your child on your scheduled date and time!

Date: 07/21/2021 (Wed.)

Created by:   LSR7 Parents as Teachers
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Location Time (CDT) Appointment Slot
Great Beginnings Early Education Center 8:00am  

DIAL Screening (4)

1 of 4 slots filled

DIAL Screening (4)


DIAL Screening (4)

2 of 4 slots filled

DIAL Screening (4)

1 of 4 slots filled

DIAL Screening (4)


DIAL Screening (4)

1 of 4 slots filled
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