Providers' Telehealth Tracker
Email address *
Name (First and Last) *
Your answer
To Our Dear Providers:
In light of the COVID-19 outbreak and the recent directive banning face-to-face therapy for early intervention, we would like to capture a snapshot of your ability to provide services based on your infection status, your current caseload, your preferences, and, the preferences of your parents!
First, let's have a quick Health Status Check. Please answer the following truthfully (choose all that apply). *
What's your total Caseload as of today? *
What Service Delivery Options are you willing to provide during the emergency period. *
How many of your families are willing to do Telehealth service? *
How many children in your caseload are ready for telehealth (parental consents to do telehealth and SC checklist are complete and uploaded to NYEIS)? *
How many families are unwilling to try Telehealth services? *
Why are the parents of your children or you as a therapist unwilling or uncomfortable trying Telehealth? *
Please list the EIIDs of the children who are ready for Telehealth:
Your answer
Please list the EIIDs who you need assistance getting telehealth forms (separated with comma or space):
Your answer
Is there anything else we can help you with?
Your answer
Thank You for Participating! For more COVID19 related materials, please click on this link, please visit our website:
A copy of your responses will be emailed to the address you provided.
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