Posted on 03/14/2017 at 10:04 AM by Liz Determan

This is information was received from the Iowa Administrators Leadership Academy.  It is an example of a home visit questionnaire teachers may be interested in using when they make home visits:

Home Visit with Parent:

  1. Tell me about your school experiences and your child’s school experiences before coming they came to our school.  Any other information about your child that you want me to know.
  2. What is going really well or working for student at school?
  3. What isn’t working or what are challenges at school?
  4. What could the school do better to support your child?
  5. What are your hopes and dreams for your child?
  6. Tell me your favorite story or memory about your child.

School Information:

  1. Demographics information
    1. Age
    2. Grade
    3. Race/Ethnicity
    4. Years in schools in United States
  2. Services that are being provided
  3. Assessment data
  4. Any other relevant data (attendance, social/emotional)

In light of all this information, what is one thing that you will do to improve the outcome for this student at your school?

Card Stock – take photo of student and put on front; and on back this information.

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