This survey is intended to gather information regarding the use of physical restraint and seclusion ("time out" rooms") in relation to a student who has an Individualized Education Program (IEP) or a 504 Plan or has had an IEP or 504 Plan within the past two years. If you would like to participate in the survey on behalf of more than one student, please complete a SEPARATE survey for each student. Thank you.

Question Title

* 1. What is your relationship to the student about whom you are completing this survey?