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Family Survey Scripts for SCs

Modified for Virtual Visits or Phone Calls

Service Coordinator Script When Providing the AzEIP Family Survey to Families:

This family survey is your opportunity to provide feedback on your experience with early intervention. It includes questions about the services provided to your child, accessibility to resources, your AzEIP Team, and your family’s overall experience. Your participation in this survey is so valuable, I would love to give you the opportunity to fill it out right now, confidentially. I will send you the link to the survey which gets sent directly to the AzEIP State Office. We welcome your comments both encouraging and constructive as they help us shape the program for the future and provide valuable personal feedback. I will send you the link now (English, Spanish) and stay on the call/video chat with you in case you have any questions while you are filling it out. You will need your survey number which is [give the family the child’s I-TEAMS number].

Most families will complete the survey when asked and will give it back to their Service Coordinator. However, if a family says they don’t want to fill it out right now, follow up with the following.

Script: You also have the option of completing the survey with a member of the AzEIP staff by calling (602)532-9960 and letting them know you would like to complete the family survey.

Service Coordinator Script When Providing the AzEIP Family Survey to Families In-Person:

This family survey is your opportunity to provide feedback on your experience with early intervention. It includes questions about the services provided to your child, accessibility to resources, your AzEIP Team, and your family’s overall experience. Your participation in this survey is so valuable, I would love to give you the opportunity to fill it out right now, confidentially. We will seal it in this envelope and return it to the AzEIP State Office. We welcome your comments both encouraging and constructive as they help us shape the program for the future and provide valuable personal feedback.

Most families will complete the survey when asked and will give it back to their Service Coordinator. However, if a family says they don’t want to fill it out right now, follow up with the following.

Script: You have the option of mailing it in or completing it electronically. To complete it electronically, go here and enter your survey number. Your survey number is [give the family the child’s I-TEAMS number].

**The script for in person family survey delivery has been developed by the Family Survey Committee of the Interagency Coordinating Council for Infants and Toddlers in conjunction with families, providers, stakeholders, and Service Coordinators. It has been adapted for delivering the family survey through alternative means during the COVID-19 response.

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