Special Education Self Review Parent Survey Question Title * 1. What is your child's school? Question Title * 2. What is your child's age? Question Title * 3. What is your child's primary exceptionality /disability? Autism Established Medical Disability Orthopedic Impairment Speech or Language Impairment Deaf-Blindness Hard of Hearing Other Health Impaired Traumatic Brain Injury Deafness Intellectual Disability / Mental Retardation Visual Impairment including Blindness Emotional Disturbance Multiple Disabilities Specific Learning Disability Question Title * 4. What is your child's ethnicity? Not Hispanic or Latino Hispanic or Latino Intentionally Left Blank Question Title * 5. What is your child's race? (select one or more) American Indian or Alaska Native Black or African American White Asian Indian Cambodian Chinese Filipino Hmong Japanese Korean Laotian Other Asian Vietnamese Hawaiian Guamanian Samoan Tahitian Other Pacific Islander Question Title * 6. Does the district make a good faith effort to assist your child with achieving the goals and objectives or benchmarks listed on his/her Individualized Education Program? Yes No Don't Know Question Title * 7. Do you receive progress reports on how your child is meeting his/her Individualized Education Program / Individualized Family Service Plan (IEP/IFSP) goals/outcomes at least as often as the regular report card schedule? Yes No Don't Know Question Title * 8. Are the services your child is receiving in accordance with his/her IEP? Yes No Don't Know Question Title * 9. Do you receive a copy of your parental rights (procedural safeguards) at least one time per year? Yes No Don't Know Question Title * 10. Did the school district facilitate parent involvement as a means of improving services and results for your child? Yes No Don't Know Next