Parent Instructions
Enter the information exactly as it appears on the assignment slip given to you by your provider.
Child and clinic information
Important note: please be sure to enter the child's full or formal first name. Do not use nicknames (like Bob for Robert or Suzie for Susan). Do not include designations such as Jr, II, etc. behind the last name.
When completing a rating please allow yourself about 15 minutes. Your answers are saved as you go, but an unfinished rating is not kept after 60 minutes without activity or once you close your browser.
Please make sure you answer all items. You are not done until you have reached the final page and then have selected Finish.
Where do I find this information?
The case number and clinic ID are printed on the assignment slip from the child's clinic. If the information doesn't match, please contact the clinic.