1. The consultant responded to my referral in a timely manner. 4

2. The consultants role was clearly explained to me. N

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?
Using the provided resources (books, star) for calming and talking through incidents.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Yes, I think my consultant was very helpful. She listens to my concerns each time I work with her and offers me validation for my feelings, new resources, and better ways to communicate with families. She gives me tips that she has picked up from other centers and does everything she can to help. This service has helped me when I was so frustrated I was ready to quit.

14. How can this consultation service be improved?
N/A

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 all of the help this service offers.

OPTIONAL - Consultants Name:

OPTIONAL - Your Name: