Workplace Needs Assessment Enquiry Form Question Title * 1. Name: (Required.) Question Title * 2. Email: (Required.) Question Title * 3. Contact number: (Required.) Question Title * 4. Organisation: (Required.) Question Title * 5. How many employees do you have? (Required.) Question Title * 6. How many dyslexic employees do you have that you know of? (Required.) Question Title * 7. Has the employee been diagnosed as dyslexic? (Required.) Yes No Question Title * 8. When are you looking to book this assessment? (Required.) Question Title * 9. Have any recommendations already been put in place for the dyslexic employee? (Required.) Question Title * 10. Anything else you would like to add? Done