Home and Hospital Teaching
Classroom Teacher Survey
Check all applicable answers.
School Level
Elementary
Middle
High
Subject Area Taught
Signature (optional)
Survey Questions
How did you find out about the student's transfer to home teaching?
H/H Memo/Form 13
Guidance
Administration
Home Teacher
Parent
Other (Please specify)
Did the home teacher meet with you personally?
At the beginning of the assignment
During the assignment
At the end of the assignment
Never
Other (Please specify)
How much prior notice did you have of the home teacher's need to meet with you or in any way coordinate with you?
What assistance did the home teacher ask from you?
Books
Other printed material
Audio-visual materials
Lesson plans
Curriculum guides
Information on grading
Other (Please specify)
Did you feel the home teacher's requests were:
Reasonable
Unreasonable
Comments
Did you feel you were appropriately involved in planning and grading for the student?
Yes
No
Comments
Do you feel the student made good academic progress while on Home and Hospital Teaching?
Yes
No
Comments
Did you know anything about the Home and Hospital Teaching Program prior to your involvement with this student?
Yes
No
Comments
Are you interested in hearing more about programs like this one for sick or disabled students?
Yes
No
Other Comments, Suggestions or Questions:
H/H Form 5