Child's Name:
My child is in:  and is:
Your relationship to the child:


Please check one response for each question:
 
The performance of the clinician who worked with my child was:
Poor Fair Good Very Good Excellent
 
The program overall was:
Poor Fair Good Very Good Excellent
 
My child's experience in the Literacy Center was:
Poor Fair Good Very Good Excellent
 
The Literacy Center's atmosphere and appearance was:
Poor Fair Good Very Good Excellent
 
The Faculty and Staff's professionalism was:
Poor Fair Good Very Good Excellent
 
Would you recommend this program to others?
Yes No
 
Would you be interested in having your child participate in other programs offered at the Literacy Center?
Yes No
 
Do you think this program improved your child's reading skills/abilities?
Yes No
Why or why not?
 
Other comments or suggestions: