Tell Us About Your Call

Thank you for taking the time to tell us about your call. We know each call is different because each child, youth, caller(s), and specialist creates a unique situation.

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* 1. What is your service branch?

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* 2. What is the name of your installation?

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* 3. Please select your Specialist.

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* 4. Please rate your level of concern about the child, youth, or situation you called to discuss.

  None Low Medium High
Before the call
After the call

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* 5. Did you gain new insights about the child or youth's strengths, challenges, and needs in your program?

  Slightly better understanding Moderately better understanding Significantly better understanding N/A - I had a good understanding before the call
Strengths
Challenges
Needs

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* 6. Did you and the Specialist develop goals and/or additional strategies for supporting the child, youth, or needs in your program?

No, not at all Somewhat Yes, definitely
Clear
i We adjusted the number you entered based on the slider’s scale.
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