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PAT - Parent Satisfaction Survey
[Visitor Login]
Parent Educator Name
First Name
M.
Last Name
First Name / Last Name
Name (Optional)
First Name
M.
Last Name
First Name / Last Name
Email Address (Optional)
Would you like someone to contact you regarding this survey?
Yes
No
How would you rate your overall experience with Parents as Teachers?
Excellent
Good
Satisfactory
Fair
Poor
How often do you ask your PE questions about the lesson?
Always
Often
Occasionally
Rarely
Never
How often do you ask your PE for advice that is not related to the lesson plan?
Always
Often
Occasionally
Rarely
Never
How often is the information you get from your PE something you have never heard or read before?
Always
Often
Occasionally
Rarely
Never
How often do you do the parent-child activities suggested by your PE?
Always
Often
Occasionally
Rarely
Never
How often do you try to use discipline and guidance techniques like those suggested by PAT or your PE?
Always
Often
Occasionally
Rarely
Never
How much of the time are the activities you do with your child things you learned from PAT or your PE?
Always
Often
Occasionally
Rarely
Never
How often do you buy toys or play materials because they wer listed on the PAT handouts or recommended by your PE, or because your child liked playing with something like those toys provided during a home visit?
Always
Often
Occasionally
Rarely
Never
How often have you tried something new to do with your child because of your involvement with PAT?
Always
Often
Occasionally
Rarely
Never
How often does your PE ask you whether you have tried the suggestions from previous home visits?
Always
Often
Occasionally
Rarely
Never
I am very satisfied with Parents as Teachers.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I would recommend this program to a friend.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Parents as Teachers has helped me be my child's best first teacher.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Parents as Teachers has strengthened my child's development.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I set and reached a child development and/or parenting goal with my parent educator.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
What has been most helpful to you and your children?
What could be improved?
Additional Comments