In an effort to better understand how we can serve your needs as parents/caregivers of a child receiving Exceptional Student Education Services in Brevard and Volusia Counties, please complete this needs assessment and mail it to FDLRS East, 2700 Judge Fran Jamison Way, Viera, FL 32940 To complete this form on line go to: https://goo.gl/forms/zGIs7iwjw6evXvSj2

Thank you for your participation!

Parent Name:
Student Name(s):
Email: / Telephone:
School/County:
Grade Level: (circle)
Pre-K / K-6 / 7-8 / 9-12 / 12+
School Type: (circle)
Charter / Private / Public / Other (Hospital/Homebound/Home)
Best Time to Contact Me: (circle)
Before School / During School / After School / Evenings / Saturdays
Preferred Method of Communication: (circle)
Telephone/Text / Email / School Flyer/Peach Jar
I would like more information and/or training on the following topics:
Accommodation and modifications Assisting my child with homework
Building relationships with school personnel – communication strategies
Creating learning opportunities at home Creating strategies for managing behaviors
Using technology to support learning Language activities for children
Methods for promoting self-esteem and motivation Movement, exercises and activities to assist with learning
Nutrition and learning / Organizing educational records (binder workshop) Overcoming bullying
Toilet training
Promoting problem solving and positive social skills Understanding impact of peers
Understanding the IEP process Understanding procedural safeguards
Understanding psycho-educational evaluations
Understanding transition process – Early Steps through high school
Understanding transition to post high school
Area community resources: APD med waiver, CARD, PAL
Other:
I am also interested in:
Parent support groups Parenting classes
Attending a local disability related conference
Attending training/information session for parents / Information on recreational resources and social opportunities Information on a specific disability such as: learning disabilities,
emotional disabilities, autism, Attention Deficit Disorder, Traumatic Brain Injury.
Other:
Best Time to for me to attend workshops or training is: (circle all that apply)
Before School / During School / After School / Evenings / Saturdays