Family Survey data helps our program ensure that we are meeting the needs of families and helps us with program improvement planning. Your time and answers are greatly appreciated!

Please select the answer that best describes your family right now. You will notice that the responses include the word “we.” This refers to your family. It’s okay if you are answering just for yourself (your own opinion or experience) or as a family with a shared opinion or experiences. You are rating your family's experience in the early intervention program as a whole, from referral to transition or exit.

If you have questions or need assistance, please call 501-682-8699.

**The following information is collected for reporting purposes only.

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* Race: You may select more than one.

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* Hispanic or Latino Ethnicity: A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

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* What type(s) of early intervention service does your child and family receive? May choose more than one.

early intervention services are listed on your IFSP

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* My service coordinator's name is ___________.

Your service coordinator schedules your IFSP team meetings. Your service coordinator's name is listed on your IFSP.