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. 3

4. I believe the consultation service was helpful. 3

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. 3

9. The consultation service positively affected the way I relate to children. 3

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

11. I feel the referring situation has improved. 3

12. What is ONE thing youre doing differently because of the consultation service you received?
Giving limited, focused options more often. For example, child has to get dressed so asking "do you want to wear the red shirt or the blue shirt?"

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Yes, they are willing to meet with families and anyone involved in the child's life during a consultation.

14. How can this consultation service be improved?
I think that it would be wonderful if both the consultant (who mostly met with the educator) and the case worker (who mostly met with the family) could come together and meet with the educator more regularly. That way the educator is also informed of what the case worker is doing with the family, in case there is something that the educator could continue in the classroom.

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: