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* 1. Date

Date

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* 2. What Program area does your child attend at Center Avenue?

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* 3. I feel Center Avenue staff are welcoming

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* 4. I am asked for input about the strengths/needs of myself or my family

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* 5. I have helped provide input or have helped create academic and/or behavioral goals for my child

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* 6. I am able to openly communicate with my child's school without issue

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* 7. Center Avenue staff respond to my questions and concerns in a timely manner

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* 8. The Center Avenue principal has been supportive to the needs of my child and family

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* 9. Center Avenue staff are respectful, friendly, and polite

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* 10. Center Avenue staff communicate with me on a consistent basis

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* 11. I receive updates on progress towards my child's academic and behavioral goals

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* 12. I believe Center Avenue staff are focused on doing what is best for my child

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* 13.  Center Avenue has helped me/my family

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* 14. What is Center Avenue doing well?

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* 15. What challenges have you encountered with Center Avenue?

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* 16. Do you have any additional feedback on how Center Avenue could better support the needs of your child and/or family?

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* 17. Your name (providing your name is totally optional)?

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