* 1. What school are you affiliated and grade do you teach?

  Pre K Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade 6th grade 7th grade 8th grade Other
Austinville
Banks-Caddell
Brookhaven
Frances Nungester
Somerville Road
West Decatur
Woodmeade

* 2. Have you referred a child/children to the FACT program?

* 3. What services did you refer them for? Check all that apply.

* 4. Did the child/children receive the assistance they were referred to FACT for?

* 5. Did you notice a change in the child/children's classroom performance after the referral?

* 6. Did you notice an improvement in parental involvement after you referred a child/children to FACT?

* 7. Did the FACT program staff respond to the referral in a professional manner?

* 8. Did the FACT program staff respond to the referral in a timely manner (within one week of the referral)?

* 9. Do you feel the FACT program has been helpful to you as an educator?

* 10. Do you feel the FACT program and its services improved your classroom environment?

* 11. Additional Comments:

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