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?
We have added in a few things to our circle time routine that are designed to help with impluse control and turn taking. It was a simple way to help support the growth of these skills and gives us daily practice.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Absolutely would recommend. I consider myseld a veteran care provider at this point in my career and these services are still beneficial and relevant to my program. I very much appreciated feeling heard and supported while working on challenging behaviors and the new perpsective and insight from a qaulified individual made me feel empowered and encouraged to stay patient and truly meet the child we were working with where she was at. Overall, we were able to see tremendous personal growth and my relationship with this child has become strengthened and she feels more secure in our program. It was a "win-win" for everyone.

14. How can this consultation service be improved?
I have no feedback in this area at this time. We had a 100% postive experience with Hannah and the services she provided.

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: