OCALI Lending Library - Resource Gallery of Interventions Evaluation

Question Title

1. Patron Name

Question Title

2. Email Address

Question Title

3. Are you a person with a disability?

Yes

Question Title

4. Are you a family member of a person with a disability?

Yes

Question Title

5. Are you a professional working with a person with a disability?

Yes

Question Title

6. Title/Role

Question Title

7. Accession Number

Refer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

Question Title

8. Date Requested

Please enter the date you requested the item below:

Date

Question Title

9. Date Received

Please enter the date you received the requested item below:

Date

Question Title

10. County

Question Title

11. Zip Code

Question Title

12. School District or Organization

If you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

Question Title

13. What resource(s) have you used in your professional practice?

Behavior/Contingency Maps

Behavior Cue Cards for Staff

Breathing Cards

Choice Boards

Conversation Maps

Conversation Starter Cards

First-Then-Board

Graphic Organizers

Health and Wellness Narratives

Incredible 5-Point Scale

Power Cards

Reminder/Cue Cards

SOCCSS

Social Autopsy

Stress Thermometer

Token Economies

Turn-Taking Supports

Voice Volume Meter Scales

What to Do Cards

Question Title

14. How have you used the Resource Gallery of Interventions? Please select all that apply:

Used directly with individuals

Used to provide professional development to others

Shared with colleagues

Shared with families

Other (please specify)

Question Title

15. Tell us how the interventions and information from the Resource Gallery made an impact on your practice, on the support you provided to families, and on the families:

Question Title

16. What other strategies would you recommend to be included in the Resource Gallery?

Question Title

17. Which best describes how you found out about this resource?

OCALI Website

OCALI Training

OCALICON

Friend, Colleague, or Coworker

Search Engine Result (e.g. Google, Bing, etc.)

Promotional Email

Social Media

Partner Organization's Website

Partner Organization's Training

Partner Organization's Conference

OCALI Lending Library - Resource Gallery of Interventions Evaluation

Question Title

* 1. Patron Name

Question Title

* 2. Email Address

Question Title

* 3. Are you a person with a disability?

Question Title

* 4. Are you a family member of a person with a disability?

Question Title

* 5. Are you a professional working with a person with a disability?

Question Title

* 6. Title/Role

Question Title

* 7. Accession NumberRefer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

Question Title

* 8. Date Requested

Question Title

* 9. Date Received

Question Title

* 10. County

Question Title

* 11. Zip Code

Question Title

* 12. School District or OrganizationIf you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

Question Title

* 13. What resource(s) have you used in your professional practice?

Question Title

* 14. How have you used the Resource Gallery of Interventions? Please select all that apply:

Question Title

* 15. Tell us how the interventions and information from the Resource Gallery made an impact on your practice, on the support you provided to families, and on the families:

Question Title

* 16. What other strategies would you recommend to be included in the Resource Gallery?

Question Title

* 17. Which best describes how you found out about this resource?

Question Title

* 18. Other comments or technical issues that need our attention (repair, missing components, items not working):

1. Patron Name

2. Email Address

3. Are you a person with a disability?

4. Are you a family member of a person with a disability?

5. Are you a professional working with a person with a disability?

6. Title/Role

7. Accession Number

Refer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

8. Date Requested

9. Date Received

10. County

11. Zip Code

12. School District or Organization

If you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

13. What resource(s) have you used in your professional practice?

14. How have you used the Resource Gallery of Interventions? Please select all that apply:

15. Tell us how the interventions and information from the Resource Gallery made an impact on your practice, on the support you provided to families, and on the families:

16. What other strategies would you recommend to be included in the Resource Gallery?

17. Which best describes how you found out about this resource?

18. Other comments or technical issues that need our attention (repair, missing components, items not working):