Teacher Interview Questionnaire
Personal Information:
Full Name
First Name
Middle Initial
Last Name
Grades Taught
Please Select
PK-K
1-3
4-5
6-8
9-12
How Many Student Are On Your Caseload?
How Many Students Are Participating In The Program?
Please List Their Names and Disabilities
What self-monitoring strategies have you implemented with your students?
List Each Strategy Used
Why Did You Choose These Strategies?
Which strategies are the most utilized among your participants?
Rate each students' behavior improvement from 1 to 5 with 1 being Needs Improvement and 5 being Excellent.
1
Do you see long term success with the program?
Are students rewarding for their behavior improvements? How so?
Do you feel a decrease in teacher burnout?
Do you feel this program could prevent professional burnout for other educators?
Overall, was this program helpful?
1
2
3
4
5
Submit
Should be Empty: