In an attempt to continually improve Special Education programs, processes, and services, we request your input in evaluating current services and identifying
areas that may need improvement. Please take a few minutes to complete this survey by providing your response to each item. Your input is greatly
appreciated. Please return this survey to_________________________________________ by _____________________.
Please check any school activities you participated in during the past school:
____IEP Team Meetings
____Eligibility Committee Meetings
____Student Assistance Team Meeting
Have you participated in training offered by: (please check all that apply)
____Parent Educator Resource Center (PERC)
____Your Child’s School
Was this training of benefit to your child/family?
Please list topics of parent training that would be helpful for you. (Please use the back of this sheet to list your requests.)
During the past school year, how did you and the school communicate about your child? (Please check all that apply)
____ Written Notes/Letters
____Regular Progress Reports
____Notebooks/organizers sent between home/school
____IEP Team Meeting Notices
____Eligibility Committee Meeting Notice
____Procedural Safeguards Notice (pamphlet about rights)
____ E-mail/Web Site
If your child was evaluated or reevaluated, did you provide information to the evaluators (parent report)?
If you attended the IEP Team meeting, did you actively participate in discussing your child’s IEP needs?
Do you use information from working with your child in the development of your child’s IEP?
Does the IEP team use this information in the development of your child’s IEP?
How often do you help your child with homework related to the IEP objectives? _____ (hours per week)
Has your child been invited to participate in tutoring programs before school, after school or on faculty senate days? ____Yes ____No
Does your child participate in school sponsored extra-curricular activities?____Yes ____No If no, explain ______________________________
If your child has been disciplined in any of the following ways this year, please indicate the number of days:
_____ In-School Suspension
____ Out of School Suspension
____ Bus Suspension
As part of the discipline process, did the following take place:
___ the IEP was reviewed/revised to address behavior
(Please check all that apply)
___ behavior intervention plan was developed or revised
___ functional behavior assessment was conducted/reviewed
Please indicate your level of satisfaction with the following special education programs and services by placing a checkmark in the appropriate
Uncertain or Not
Student Assistance Team
physical therapy, speech,
Extended School Year Eligibility/Services
Thank you for your input. If you have a concern and wish to be contacted, please complete the following:
School ____________________Parent’s Signature: