NEW RBT Feedback Form
An opportunity for each technician to anonymously provide feedback to guide clinic procedures and supports for clients and technicians. If there is a specific grievance about an event or person, please complete the grievance form instead. Note: Only Shelby reviews the specific feedback provided in this form to disseminate to the supervising BCBAs and other stakeholders as necessary. 
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Name (if you want, don't have to)
Which Clinic does this feedback apply to? (if you have feedback for more than one clinic, complete this form multiple times, once for each clinic) By providing this information, we are better able to use the feedback to make changes in the appropriate setting.  *
Provide any positive feedback regarding current clinic systems that you feel is working well:
Provide any constructive feedback regarding current clinic systems that you feel is working well:
Provide any positive feedback regarding BCBA supervision that you have received within the last month:
Provide any constructive feedback regarding BCBA supervision that you have received within the last month:
Is there anything else that you would like for us to know at this time? (concerns, ideas, etc.)
Give a shout out to another staff member!
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