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1. Was the monitor(s)courteous and professional throughout the monitoring process?

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2. Was a confirmation letter received in a timely manner that verified the scheduled date?

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3. Did the monitoring staff arrive in a timely manner?

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4. Did the monitor(s) explain the purpose of the review and summarize the process?

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5. Did your monitor provide meaningful technical assistance related to any policy amendments, updates, or changes?

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6. During the exit conference, did the monitor(s) provide examples of items that met policy compliance and/or needed strengthening in your documentation?

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7. Did your monitor provide the written (or electronic) results of your monitoring visit within the specified time-frame?

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8. Was the monitor(s) able to answer any questions you may have posed regarding Early Intervention policy, procedure, billing/administration requirements, etc.?

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9. Did the review process identify resources to support your practices (Early Intervention Provider Handbook, EITP links, referral to direct support from CBO, Provider Connections, EI Clearinghous)?

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10. Comments

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11. 1. PROVIDER/AGENCY
     2. DATE
     3. MONITOR NAME

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