EI Telehealth Family Survey
The Department of Public Health (DPH) and the Early Intervention Parent Leadership Project (EIPLP) would like to hear about your experience with receiving EI services during the COVID-19 pandemic. Below are 10 questions that ask you about telehealth services, also sometimes called tele-intervention. It should take less than 10 minutes to complete and all questions are optional. Please only complete one survey per family. If you do not have access to the Internet, please contact the EIPLP at (617) 645-1763 from 12pm - 8pm on Mondays and Wednesdays, to complete the survey in person or if you need an interpreter.

This survey is also available in the following languages at www.eiplp.org/coronavirus-covid-19/:
Arabic
Haitian-Creole
Portuguese
Spanish
Vietnamese
How old is your child?
Clear selection
How long have you received EI services?
Clear selection
How would you describe yourself? (please check all that apply)
Telehealth services were explained to me by my EI service provider.
When did your EI program ask you if you would like to have EI telehealth services?
My EI service provider offered telehealth services via: (please check all that apply)
Are you choosing to have some or all of your services provided as a telehealth service?
If you decided not to have visits by telehealth, could you tell us why? (please check all that apply)
What services have you received by telehealth? (please check all that apply)
On a scale of 1 (very satisfied) to 5 (not satisfied), how satisfied are you with your telehealth services and why?
Thank you for sharing your experience with us. Your input is vital to helping to make EI services and supports in Massachusetts better!
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