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. 4

9. The consultation service positively affected the way I relate to children. 4

10. Overall, I am satisfied with the consultation service I recieved. 4

11. I feel the referring situation has improved. 4

12. What is ONE thing youre doing differently because of the consultation service you received?
I feel my biggest take away from working with the consultant is I now have better understanding that all children and families have a lot going on and grace and patience is needed with all.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Absolutely- Ms. Rachel is a gem. She really listens to my concern when working with children and their families. She offers positive guidance and strategies the are usehelp and helpful. She also helps me see things a different way. I feel valued, seen and heard with Ms. Rachel.

14. How can this consultation service be improved?
I can't think of anything at this time.

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:
I really appreciate having this service made available to our child care center. It's helpful and useful.

OPTIONAL - Consultants Name:

OPTIONAL - Your Name: