Conversations with Parents Question Title * 1. Which session did you attend? Panel Discussion – 6/25 Back to School – 7/2 Question Title * 2. I am a ... Family Member/Parent Professional Question Title * 3. I gained useful knowledge on this topic Low 1 2 3 High 4 Low 1 2 3 High 4 Question Title * 4. I feel better prepared to use this knowledge to meet my needs Low 1 2 3 High 4 Low 1 2 3 High 4 Question Title * 5. I found the information and presentation to be of high quality and understandable. Low 1 2 3 High 4 Low 1 2 3 High 4 Question Title * 6. Comments: Question Title * 7. Age of Child: Birth to 2 yrs 3-5 yrs 6-11 yrs 12-14 yrs 15-18 yrs 19 yrs+ I prefer not to answer Question Title * 8. Check All That Apply: ADD/ADHD At Risk/Developmental Delay Autism Cerebral Palsy Cognitive Disability Deaf/Blind Deaf/Hearing Impaired Emotional Disability I prefer not to answer Multiple Disabilities Orthopedic Impairment Other Health Impairment (OHI) Specific Learning Disability Speech/Language Impairment Suspected/Not Diagnosed Traumatic Brain Injury (TBI) Visual Impairment/Blind Other (please specify) Question Title * 9. Parent Ethnicity: African American Asian/Pacific Bi-racial Caucasian Hispanic/Latino Native American I prefer not to answer Other (please specify) Done
