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?
Hannah was great and always there for us when we needed her. Hannah supported us with children that were challenging for us. She told us sometimes children misbehave because they are seeking a relationship and a connection with you. Sometimes it can be hard to develop relationships with children misbehaving because you’re trying to correct the behavior. Building the relationship is so important for example play with them one on one, listen to them, encourage the child to express their feeling openly.

13. Would you recommend this consultation service to other childcare providers? Why or why not?
Yes Absolutely!!

14. How can this consultation service be improved?

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: