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 have created a calming corner for children to use when they need a break.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Absolutely, she was very helpful and supportive with the needs and service provided to teachers, students and connecting with families.

14. How can this consultation service be improved?
Honestly I think she did an amazing job and I enjoyed how professional she was in every aspect of her service. Maybe getting parents parenting classes or early childhood programs services to give to families. This would be helpful for many young families to hear how to support their child when having meltdowns or emotional struggles.

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:
Thank you for all your guidance!

OPTIONAL - Consultants Name:

OPTIONAL - Your Name: