Hombound Survey

This survey is for families of students who have received Homebound Services. Please take a few moments to rate your satisfaction with your homebound experience. We use your input to evaluate our program which helps us work towards improving our services to students and families. Thanks for your time!

	Very satisfied	Somewhat Satisfied	Somewhat dissatisfied	Very dissatisfied	Do not know
Helpfulness of school staff when initiating the Homebound Application	Helpfulness of school staff when initiating the Homebound Application Very satisfied	Helpfulness of school staff when initiating the Homebound Application Somewhat Satisfied	Helpfulness of school staff when initiating the Homebound Application Somewhat dissatisfied	Helpfulness of school staff when initiating the Homebound Application Very dissatisfied	Helpfulness of school staff when initiating the Homebound Application Do not know
Clear directions for required paperwork to complete the Homebound Application	Clear directions for required paperwork to complete the Homebound Application Very satisfied	Clear directions for required paperwork to complete the Homebound Application Somewhat Satisfied	Clear directions for required paperwork to complete the Homebound Application Somewhat dissatisfied	Clear directions for required paperwork to complete the Homebound Application Very dissatisfied	Clear directions for required paperwork to complete the Homebound Application Do not know
Cooperation of school staff when supplying school assignments and materials	Cooperation of school staff when supplying school assignments and materials Very satisfied	Cooperation of school staff when supplying school assignments and materials Somewhat Satisfied	Cooperation of school staff when supplying school assignments and materials Somewhat dissatisfied	Cooperation of school staff when supplying school assignments and materials Very dissatisfied	Cooperation of school staff when supplying school assignments and materials Do not know
Appropriate amount of school work assigned to student while receiving Homebound Services	Appropriate amount of school work assigned to student while receiving Homebound Services Very satisfied	Appropriate amount of school work assigned to student while receiving Homebound Services Somewhat Satisfied	Appropriate amount of school work assigned to student while receiving Homebound Services Somewhat dissatisfied	Appropriate amount of school work assigned to student while receiving Homebound Services Very dissatisfied	Appropriate amount of school work assigned to student while receiving Homebound Services Do not know
Level of support received from the school when the student returned to school	Level of support received from the school when the student returned to school Very satisfied	Level of support received from the school when the student returned to school Somewhat Satisfied	Level of support received from the school when the student returned to school Somewhat dissatisfied	Level of support received from the school when the student returned to school Very dissatisfied	Level of support received from the school when the student returned to school Do not know
Promptness of initial homebound teacher contact	Promptness of initial homebound teacher contact Very satisfied	Promptness of initial homebound teacher contact Somewhat Satisfied	Promptness of initial homebound teacher contact Somewhat dissatisfied	Promptness of initial homebound teacher contact Very dissatisfied	Promptness of initial homebound teacher contact Do not know
Timeliness of start of homebound services	Timeliness of start of homebound services Very satisfied	Timeliness of start of homebound services Somewhat Satisfied	Timeliness of start of homebound services Somewhat dissatisfied	Timeliness of start of homebound services Very dissatisfied	Timeliness of start of homebound services Do not know
Flexibility of homebound teacher's schedule	Flexibility of homebound teacher's schedule Very satisfied	Flexibility of homebound teacher's schedule Somewhat Satisfied	Flexibility of homebound teacher's schedule Somewhat dissatisfied	Flexibility of homebound teacher's schedule Very dissatisfied	Flexibility of homebound teacher's schedule Do not know
Communication with homebound teacher	Communication with homebound teacher Very satisfied	Communication with homebound teacher Somewhat Satisfied	Communication with homebound teacher Somewhat dissatisfied	Communication with homebound teacher Very dissatisfied	Communication with homebound teacher Do not know
Quality of instuction given by homebound teacher	Quality of instuction given by homebound teacher Very satisfied	Quality of instuction given by homebound teacher Somewhat Satisfied	Quality of instuction given by homebound teacher Somewhat dissatisfied	Quality of instuction given by homebound teacher Very dissatisfied	Quality of instuction given by homebound teacher Do not know

Very satisfied

Somewhat Satisfied

Somewhat dissatisfied

Very dissatisfied

Do not know

Helpfulness of school staff when initiating the Homebound Application

Helpfulness of school staff when initiating the Homebound Application Very satisfied

Helpfulness of school staff when initiating the Homebound Application Somewhat Satisfied

Helpfulness of school staff when initiating the Homebound Application Somewhat dissatisfied

Helpfulness of school staff when initiating the Homebound Application Very dissatisfied

Helpfulness of school staff when initiating the Homebound Application Do not know

Clear directions for required paperwork to complete the Homebound Application

Clear directions for required paperwork to complete the Homebound Application Very satisfied

Clear directions for required paperwork to complete the Homebound Application Somewhat Satisfied

Clear directions for required paperwork to complete the Homebound Application Somewhat dissatisfied

Clear directions for required paperwork to complete the Homebound Application Very dissatisfied

Clear directions for required paperwork to complete the Homebound Application Do not know

Cooperation of school staff when supplying school assignments and materials

Cooperation of school staff when supplying school assignments and materials Very satisfied

Cooperation of school staff when supplying school assignments and materials Somewhat Satisfied

Cooperation of school staff when supplying school assignments and materials Somewhat dissatisfied

Cooperation of school staff when supplying school assignments and materials Very dissatisfied

Cooperation of school staff when supplying school assignments and materials Do not know

Appropriate amount of school work assigned to student while receiving Homebound Services

Appropriate amount of school work assigned to student while receiving Homebound Services Very satisfied

Appropriate amount of school work assigned to student while receiving Homebound Services Somewhat Satisfied

Appropriate amount of school work assigned to student while receiving Homebound Services Somewhat dissatisfied

Appropriate amount of school work assigned to student while receiving Homebound Services Very dissatisfied

Appropriate amount of school work assigned to student while receiving Homebound Services Do not know

Level of support received from the school when the student returned to school

Level of support received from the school when the student returned to school Very satisfied

Level of support received from the school when the student returned to school Somewhat Satisfied

Level of support received from the school when the student returned to school Somewhat dissatisfied

Level of support received from the school when the student returned to school Very dissatisfied

Level of support received from the school when the student returned to school Do not know

Promptness of initial homebound teacher contact

Promptness of initial homebound teacher contact Very satisfied

Promptness of initial homebound teacher contact Somewhat Satisfied

Promptness of initial homebound teacher contact Somewhat dissatisfied

Promptness of initial homebound teacher contact Very dissatisfied

Promptness of initial homebound teacher contact Do not know

Timeliness of start of homebound services

Timeliness of start of homebound services Very satisfied

Timeliness of start of homebound services Somewhat Satisfied

Timeliness of start of homebound services Somewhat dissatisfied

Timeliness of start of homebound services Very dissatisfied

Timeliness of start of homebound services Do not know

Flexibility of homebound teacher's schedule

Flexibility of homebound teacher's schedule Very satisfied

Flexibility of homebound teacher's schedule Somewhat Satisfied

Flexibility of homebound teacher's schedule Somewhat dissatisfied

Flexibility of homebound teacher's schedule Very dissatisfied

Flexibility of homebound teacher's schedule Do not know

Communication with homebound teacher

Communication with homebound teacher Very satisfied

Communication with homebound teacher Somewhat Satisfied

Communication with homebound teacher Somewhat dissatisfied

Communication with homebound teacher Very dissatisfied

Communication with homebound teacher Do not know

Quality of instuction given by homebound teacher

Quality of instuction given by homebound teacher Very satisfied

Quality of instuction given by homebound teacher Somewhat Satisfied

Quality of instuction given by homebound teacher Somewhat dissatisfied

Quality of instuction given by homebound teacher Very dissatisfied

Quality of instuction given by homebound teacher Do not know

Hombound Survey

Homebound Services Survey

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* 1. Who was your homebound instructor?

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* 2. Please rate your level of satisfaction with the Homebound Process and Instruction:

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* 3. Please note things you LIKED about homebound:

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* 4. Please note things you DID NOT LIKE about homebound:

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* 5. Please note any suggestions you have for improvement: