Reporting Period Data Form Please answer the following questions regarding the last reporting period. This is the period you are reporting on in your court report. If you need clarification on the time you are reporting on, please reach out to your Advocacy Supervisor. If a question does not apply to your case, please select the corresponding option rather than skipping the question. Name First Last Your Volunteer ID*This was provided to you by your Advocacy Supervisor.Case ID*This was provided to you by your Advocacy Supervisor. If you are reporting on multiple children, please write out each child’s unique case ID separated using a comma. (Ex: 123456, 654321) How many of the below meetings did you attend?Child and Family Team Meeting*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Individualized Education Program (IEP)*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Other school meetings, not counting IEPs*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Quarterly Team Meeting*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Multidisciplinary Team (MDT) Meeting*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Development Screening and Enhancement Program (DSEP)*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.Permanency Roundtable*Choose an item.123+None, but was invitedNone of these meetings were held.A meeting was held, but I was not invited.In which ways, and how often, did you have contact with your child(ren)?If you have multiple children, group the visits together.In Person Visitation*Choose an item.1234567891011+NoneVirtual Visitation (via Zoom, FaceTime, House Party)*Choose an item.1234567891011+NoneOver the telephone*Choose an item.1234567891011+NoneVia text messaging*Choose an item.1234567891011+NoneContact with the caregiver/placement staff regarding the child(ren)*Choose an item.1234567891011+NoneOther (mailed letters, dropped off gifts)*Choose an item.1234567891011+NoneHow many times did you facilitate the following?Select N/A if necessary.Secured funding or items for my child*Examples: My Advocacy Supervisor submitted a funding request for glasses. I received a bike from VFC.Choose an item.123+Not ApplicableHelped gain access to extracurricular activity or program*Examples: tutoring, music lessons, sports teamChoose an item.123+Not ApplicableHelped with Probation Requirements*Examples: researched community service options, assisted youth with writing apology letter, provided a list of anger management classes to youthChoose an item.123+Not ApplicableWhich professionals have you attempted to contact? Select all that apply.* Social Worker Probation Officer Parent(s) Caregiver/Group Home Therapist Teacher/School Staff Independent Living Skills Worker County Mentor Minor's Dependency Attorney Minor's Delinquency Attorney DSEP Specialist Transitional Housing Program Staff Educational Attorney (SDVLP) Foster Family Agency Social Worker Medical Provider Other Evaluate the frequency of your contact with your Advocacy Supervisor (AS) using the drop down.*Choose an item.I did not reach out, but responded when the AS contacted me.I reached out when there was a case issue.I reached out at least once a month.OtherCAPTCHA
