1. The consultant responded to my referral in a timely manner. 4

2. The consultants role was clearly explained to me. 4

3. I felt I had a good relationship with the consultant. 4

4. I believe the consultation service was helpful. 4

5. I felt listened to by the consultant. 4

6. The consultant respected my opinions. 4

7. The consultant answered my questions. 4

8. I learned new ways to help children with challenging behaviors. 0

9. The consultation service positively affected the way I relate to children. 0

10. Overall, I am satisfied with the consultation service I recieved. 3

11. I feel the referring situation has improved. 0

12. What is ONE thing youre doing differently because of the consultation service you received?
We haven't changed the way we deal with this child due to the local ISD having us implement strategies with behaviors.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Yes. I feel this service is very needed in this area.

14. How can this consultation service be improved?
I understand the need to relay positive information back to families after the consultant visits to the classroom, but it seemed to be mainly focused on the positives and the issues were sort of brushed over. The information relayed to parents didn't seem to depict the true issues we're facing with this child and we sense the parents feel like 'everything is better'. While positives need to be shared, the concerning behavior the teachers experience also need to be addressed.

15. To be answered by the family: Over the past 30 days, how many days of work or school has the family/caregiver missed due to the challenges a child has experienced while in child care?

16. To be answered by the family: Please rate your stress level related to your child’s challenges at ChildCare(please edit if you like the idea of adding it):

Other comments:

OPTIONAL - Consultants Name:

OPTIONAL - Your Name: