Through the Looking Glass Evaluation Form

Please fill out this feedback form for any of the information or services you received from TLG.

1. Are you a Parent with a disability? No
Yes

2. Are you a family member of a person with a disability? No
Yes

3. What type of work do you do? (check all that apply) Advocacy
Mental Health
Rehabilitation
Researcher
State Government
Legal
Early Intervention
Education
Practitioner
Local Government
Medical
Social Services
Not For Profit
Accessibility
Student
Other (Please specify)

4. The Product/Publication I received from TLG was: Very Useful
Useful
Not Useful
Not Applicable
Name of Product or Publication

5. The Presentation/Workshop by TLG I attended was: Very Useful
Useful
Not Useful
Not Applicable
Name of Presentation or Workshop

6. The Consultation I received from TLG was: Very Useful
Useful
Not Useful
Not Applicable
Topic of Consultation (e.g. Custody, Adaptive Equipment, General Parenting)

7. The TLG Website was: Very Useful
Useful
Not Useful
Not Applicable

8. How have you used this information? (check all that apply) Daily Parenting
Shared with others
Placed in Reference Library or for Public Display
Day-to-Day work/study
Workshops and training sessions
Conference Presentations
Other (Please specify)

9. How did you hear about TLG? Internet Search/TLG Website
Disability Resource
TLG Publication
TLG Staff
Service Provider
Medical Provider
Attended TLG Event
Other Referral Source or Specify Response Above

10. Accessible Formats Overall, has the information you have received from TLG been in a format accessible to your needs?
No
Yes

11. Overall satisfaction with TLG Excellent
Good
Average
Fair
Poor

12. What has been most helpful to you?

13. What has been least helpful to you?

Thank you so much for your feedback.