2015-16 Parent Center Program Measures Survey Data Worksheet

Parent Center Name: # of Surveys Assigned:

Instructions: After collecting surveys from the parent contacts assigned to your Parent Center, use this worksheet to record the numbers of parent answers for each question. You will submit your counts online at: http://tinyurl.com/parentprogram-survey-2016

# of Parents Responding Strongly Strongly Question Disagree Disagree Agree Agree 1a. The information or support you received from [insert name of parent center] met your needs. 1b. You were able to understand the information you received from [insert name of parent center]. 1c. The information [insert name of parent center] provided helped you learn more about how to meet your child’s needs. 1d. The information [insert name of parent center] provided was useful. 2a. You are prepared to use the information you received within the past 6 months from [insert name of parent center].

# of Parents Responding Not Strongly Strongly Question applicable Disagree Disagree Agree Agree 3a. You feel confident in your ability to work with your child’s school or service providers to meet your child’s needs.

# of Parents Responding

Question Yes Maybe No 4. Would you recommend [insert name of parent center] to your friends or family?

If parents shared with you any comments on the optional questions, please include them below. You will be asked to “Upload” the comments at the end of your on-line submission.

The optional questions: Please share any comments about the information and/or support that you received from [insert name of parent center]:

Please share any comments about how you were able to use the information that you received from [insert name of parent center]:

Please share any additional comments about your experience in getting information or support from [insert name of parent center]:

Please submit your Center’s completed survey data to: http://tinyurl.com/parentprogram-survey-2016 By Friday, December 2, 2016

Contact [email protected], if you have any questions or need assistance.