NH Preschool Technical Assistance Network SERESC, 165 South River Rd Unit F, Bedford, NH 03110 • 603-206-6800 • Joan M. Izen, MA, CCC/SLP, Project Director PTAN Child Care Inclusion Project - Monthly Consultation Report Email this report and your corresponding invoice monthly for the duration of the consultation along with any additional reports or handouts you shared with program staff (email to and . Please respond to all questions on this report form. Child Care Program Name: Consultant’s Name: Lead Teacher First and Last Name: First Name: Child’s Document each program contact using this key: *T=telephone, E=email, OTA=onsite technical assistance, OTR=onsite training, R/P=research, prep or report writing Activity Date Activity Type Total time IN MINUTES Who did you consult with? (Using key above*) (1 hour=60) (First/last names of those directly involved) Briefly respond to each of the following 6 questions: What were the key consultation issue(s) addressed this month? What recommendations did you suggest? What progress did you observe (child/teacher/classroom)?
NH Preschool Technical Assistance Network SERESC, 165 South River Rd Unit F, Bedford, NH 03110 • 603-206-6800 • Joan M. Izen, MA, CCC/SLP, Project Director PTAN Child Care Inclusion Project - Monthly Consultation Report Email this report and your corresponding invoice monthly for the duration of the consultation along with any additional reports or handouts you shared with program staff (email to and . Please respond to all questions on this report form. Consultant’s Name: Child Care Program Name: Lead Teacher First and Last Name: Child’s First Name: Document each program contact using this key: *T=telephone, E=email, OTA=onsite technical assistance, OTR=onsite training, R/P=research, prep or report writing Activity Date Activity Type (Using key above*) Total time IN MINUTES (1 hour=60) Who did you consult with? (First/last names of those directly involved) Briefly respond to each of the following 6 questions: What were the key consultation issue(s) addressed this month? What recommendations did you suggest? What progress did you observe (child/teacher/classroom)?
3.18ConsultantsReport.docx