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Early Intervention Program Parent Satisfaction Questionnaire

Complete this questionnaire only if your child was determined ineligible for services.

Dear Parent:

Please help us evaluate the Early Intervention Program by taking a few minutes to answer the questions below. Your response will be useful in determining what practices work best, and how we can refine the system for those we will be serving in the future.

Thank you in advance for your assistance.

1. My child and I were treated with dignity and respect by all early intervention professionals throughout the early intervention evaluation process.
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2. I was satisfied with my initial service coordinator.
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3. I had the opportunity to ask questions about and voice my disagreement (if any) with the evaluators and my opinions were listened to and considered.
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4. My initial service coordinator was as flexible and accommodating as possible with respect to holding appointments and evaluations at times and places which were convenient for my child and for me.
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5. The needs of my child and family were listened to and respected during the evaluation process.
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6. The evaluation agency or evaluator I chose offered me the opportunity to complete a Family Assessment
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7. The evaluators who worked with my child were professional, skilled and reliable.
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8. The evaluators explained the testing methods, used appropriate, well maintained testing materials, and all evaluators used standard precautions (hand washing, disposable gloves when necessary) during the evaluations.
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• Although your child was found ineligible for EI services, do you need information about other supports and services in the community?
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• Did your service coordinator provide information about other resources?
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• Were you given a list of evaluating agencies to choose from?
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• May we contact you for more specific details on your responses?
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Westchester County respects your privacy. Your contact information:

  • will never be shared
  • will always be kept confidential
  • will never be used in any other county government application
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Enter your ten digit phone number with no spaces.
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