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?
The collaboration and resources provided through the Michigan Model for Infant Mental Health Consultation have profoundly shaped our holistic approach to caring for children. Our consultant, Heather, has been absolutely incredible. This model extends its support beyond the children in our program, it also empowers families and childcare providers. Having access to this resource gives us confidence that every child receives high-quality care and the unwavering support of a dedicated team committed to their success.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Absolutely! We would highly recommend the Michigan Model for Infant Mental Health Consultation to other childcare providers. The resources provided through this model create a strong, unified team committed to every child's success. This level of collaboration not only enhances the quality of care but also fosters a supportive environment that reassures us as childcare providers that we are not alone. We have a network of support, guidance, and expertise to help navigate challenges and provide the best care possible. Most importantly this model helps to ensures no child is ever left behind.

14. How can this consultation service be improved?
One area for improvement would be increasing awareness and providing more opportunities for childcare providers to learn about the benefits of this model. While the impact of the Michigan Model for Infant Mental Health Consultation has been incredible, many providers may not yet be aware of the valuable support it offers. In addition to the amazing work already being done, having a fellow childcare provider serve as a liaison to connect other programs to the model could be highly beneficial. This peer-to-peer connection could help bridge gaps, foster engagement, and encourage more providers to take advantage of this invaluable resource.

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: