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ESY #6 Staying Safe and Happy at Home--Parent Feedback Form
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* Indicates required question
Date
*
MM
/
DD
/
YYYY
Parent Name
*
Your answer
Did your student attend to the lesson?
*
Yes
No
Did your student listen to the story and look at the pictures?
*
Ignored the Story
1
2
3
4
5
Enjoyed the Story
Did your student communicate using their means of communication?
*
Yes
No
They tried but struggled to communicate
Was this lesson easy or difficult to teach to your student?
*
Very Easy
1
2
3
4
5
Very Diffcult
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