__________Unified School District

Parent Interview

Dear Guardian,

In preparation for the evaluation of ______________________, please complete the following

questionnaire and any additional questionnaires attached to provide insight on your child’s current
strengths and progress, as well as your main questions and concerns regarding his/her education.
Once completed, please return this questionnaire along with the assessment plan and any other
questionnaires/documents attached to the front office (Attn: School Psychologist) by the following
date: _______________. Thank you!

Respectfully,

School Psychologist

1. What do you see as your child’s strengths, both specific to school and in general as a person?

2. What does your child struggle with as a student?

3. From your experience with your child, what strategies have helped him/her succeed the most?

4. What improvements have you noticed in your child in the past 2-3 years?
5. What are your main questions and concerns regarding your child’s school performance?

6. Has anything changed recently with your child’s behaviors?

7. Is your child taking medication? If so, which ones?

8. Any health related concerns?

Additional Comments