ABA Client Preferences Assessment Questionnaire
Share your preferences so we can better understand the client’s needs, routines, and session setup.
Client Preferences
Preferred Name
*
Preferred Communication Method
*
Phone
Text
Email
Caregiver Contact
Other
Best Times for Contact
Preferred Session Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Session Format and Environment
Preferred session location
*
Home
Clinic
School
Community
Other
Preferred session format
*
1:1
Small group
Caregiver involved
Other
Preferred session length
*
Please Select
30 minutes
45 minutes
60 minutes
90 minutes
Other
Environmental preferences
Skill Goals and Support Needs
Priority Skill Areas
*
Rows
Not a priority
Low
Moderate
High
Top priority
Communication
1
2
3
4
5
Daily living skills
6
7
8
9
10
Social skills
11
12
13
14
15
Play skills
16
17
18
19
20
Behavior support
21
22
23
24
25
School readiness
26
27
28
29
30
Learning Style Preferences
*
Rows
Not important
Slightly important
Moderately important
Very important
Essential
Clear structure
31
32
33
34
35
Visual supports
36
37
38
39
40
Repetition and practice
41
42
43
44
45
Positive reinforcement
46
47
48
49
50
Slower pace
51
52
53
54
55
Faster pace
56
57
58
59
60
Additional notes or scheduling considerations
Submit Questionnaire
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