Date

MM

DD

YYYY

Name *

First Name

Last Name

Phone

(###)

###

####

Do you feel that this teacher is informative and thorough when providing feedback on your child's progress? *

Always

Usually

Sometimes

Rarely

Never

Is positive feedback given as well as identification of needed areas of growth? *

Always

Usually

Sometimes

Rarely

Never

Do you feel that this teacher is available to provide additional help or support when needed? *

Always

Usually

Sometimes

Rarely

Never

If you have initiated contact, has this teacher responded to your satisfaction? *

Always

Usually

Sometimes

Rarely

Never

Do you and your child feel comfortable when approaching this teacher? *

Always

Usually

Sometimes

Rarely

Never

Does this teacher challenge your child so that he/she can reach his/her potential? *

Always

Usually

Sometimes

Rarely

Never

Do you feel that you and this teacher have the same goals in supporting your child? *

Always

Usually

Sometimes

Rarely

Never