If you need any help with completing this survey, you may contact the AzEIP office at (602)532-9960.  Do you prefer to complete the Family Survey in Spanish?  You can complete the Family Survey in Spanish at: https://forms.gle/6omKG29gUdn1diUK9.  

¿Prefiere la Encuesta Familiar por español?  Puede encontrar la Encuesta Familiar por español en: https://forms.gle/6omKG29gUdn1diUK9

The following is a confidential family survey to help the Arizona Early Intervention Program (AzEIP) measure the impact of early intervention services on your family.  AzEIP is required to measure the impact of early intervention services on families as part of our federal grant and the annual report to the US Department of Education's Office of Special Education Programs.  This survey is administered by the AzEIP state office.  AzEIP does not provide direct services but contracts for direct services with several programs throughout the state including Essential Therapy Solutions dba A to Z Therapies, Arizona Cooperative Therapies (ACT), Dynamite Therapy, Growing in Beauty (Navajo Nation), Hummingbird, Northland Therapy Services, Northland Rural Therapy Associates (NRTA), RISE Early Intervention Services, The Learning Center for Families (TLC) dba Root for Kids, and Sunrise Therapy.

Your family was chosen to participate in this survey because your child received early intervention services from one of AzEIP's participating programs including the Division of Developmental Disabilities (DDD), the Arizona Schools for the Deaf and Blind (ASDB), and/or a Team Based Early Intervention Services Contractor.  If you have more than one child in early intervention, you may be offered this survey more than once.  If you have taken this survey in the last 6 months for this child, you do not need to take this survey.

This survey is estimated to take approximately 5 minutes from start to finish.  AzEIP uses the National Center for Special Education Accountability Monitoring (NCSEAM) survey to measure the impact of early intervention services on your family.  If you need help or assistance with completing this survey, to request another language for this survey, or if you need to request any reasonable accommodations to take this survey, please call the AzEIP office at (602)532-9960 or e-mail: azeip@azdes.gov to request assistance completing this family survey.

Your information is kept confidential and the results of your survey are shared only with the AzEIP staff that need to know.  We will not use your personally identifying information for any purposes other than to complete this survey or follow up when you request us to do so.  Your specific answers are not linked to you personally in any of our reports nor are they shared with the US Department of Education Office of Special Education Programs.  Past results of this survey can be found with all AzEIP's public reports at: https://des.az.gov/services/disabilities/developmental-infant/azeip-publications-and-reports or more directly at https://datastudio.google.com/reporting/e3dc5cd5-fe72-416b-9e7f-c6e0060cc34b/page/rKWVC.  Reports are posted annually.

If you would like more information on how you can advise and assist the AzEIP office, you may call us at (602)532-9960 or visit: https://des.az.gov/interagency-coordinating-council-for-infants-and-toddlers.

Your responses will help guide efforts to improve services and results for children and families. We appreciate your time.