What is today's date?
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Today M-D-Y
What brought you to this survey today?
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Internet Search TRIAD Email Blast DOE Email/Newsletter/Communication Attended a TRIAD Training Directed by Administrator Word of mouth/colleague Suggested by a TRIAD consultant Facebook Twitter Partners In Education Conference (PIE) LEAD Conference Special Education Supervisor Institute Other
First Name
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Last Name
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Email Address
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Alternative Email Address (i.e., Gmail, Yahoo, etc. in case your work email bounces back)
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Phone Number
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Do you currently work in...?
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A Tennessee Public School Setting
Tennessee Charter School
Other Setting
Tennessee Public Setting (start typing the name of the district to more easily scroll to that option):
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Achievement School District Alamo Alcoa Alvin C York Institute Anderson County Arlington Athens Bartlett Bedford County Bells Benton County Bledsoe County Blount County Bradford Bradley County Bristol Campbell County Cannon County Carroll County Carter County Cheatham County Chester County Claiborne County Clay County Cleveland Clinton Cocke County Coffee County Collierville Crockett County Cumberland County Davidson County Dayton Decatur County DeKalb County Dickson County Dyer County Dyersburg Elizabethton Etowah Fayette County Public Schools Fayetteville Fentress County Franklin County Franklin SSD Germantown Gibson Co Sp Dist Giles County Grainger County Greene County Greeneville Grundy County Hamblen County Hamilton County Hancock County Hardeman County Schools Hardin County Hawkins County Haywood County Henderson County Henry County Hickman County Hollow Rock - Bruceton Houston County Humboldt City Schools Humphreys County Huntingdon Special School District Jackson County Jefferson County Johnson City Johnson County Kingsport Knox County Lake County Lakeland Lauderdale County Lawrence County Lebanon Lenoir City Lewis County Lexington Lincoln County Loudon County Macon County Madison County Manchester Marion County Marshall County Maryville Maury County McKenzie McMinn County McNairy County Meigs County Milan Millington Municipal Schools Monroe County Montgomery County Moore County Morgan County Murfreesboro Newport Oak Ridge Obion County Oneida Overton County Paris Perry County Pickett County Polk County Putnam County Rhea County Department of Education Richard City Roane County Robertson County Rogersville Rutherford County Scott County Sequatchie County Sevier County Shelby County Smith County South Carroll Stewart County Sullivan County Sumner County Sweetwater Tennessee Public Charter School Commission Tennessee School for Blind Tennessee Schools for the Deaf Tennessee State Board of Education Tipton County Trenton Trousdale County Tullahoma Unicoi County Union City Union County Van Buren County Warren County Washington County Wayne County Weakley County West Carroll Sp Dist West Tennessee School for the Deaf White County Williamson County Wilson County
Private School Setting
Clinic Setting
Home Setting
Residential Setting
Other
Thank you for completing TRIAD's intake form so that we can learn more about your current service needs. It looks like you might be from out of state or working for a private school or company who provides services to students. Currently, TRIAD training and coaching opportunities are only open to public school systems across Tennessee due to stipulations by our funders. Before closing the form, please click the Save and Return button so we can contact you in the event that we have an opportunity in the future. In the meantime, we do have an ever-growing library of online modules and archived and live webinars that you are welcome to access whenever you like. Please follow the link below to register for and access our online learning platform.https://vkc.vumc.org/vkc/triad/online/
Time Zone
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Central Time Zone Eastern Time Zone Other
Position
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General Education Teacher
Special Education Teacher
ParaEducator
Building Level Administrator (Principal or Assistant Principal)
District Level Administrator
Autism/Behavior Consultant
Speech Language Pathologist
Occupational Therapist
Physical Therapist
School Psychologist
School Counselor
School Social Worker
Other
What are you hoping to gain from working with TRIAD? What would you consider your desired outcome of pursuing educational opportunities with TRIAD (i.e., Broad knowledge of autism spectrum disorders and evidence-based practices, Student specific gains/plans, Structural/programmatic changes for my school/district/team)?
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Are you only interested in intensive behavior consultation services?
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Yes
No
If you are in need of our intensive behavior consultation services due to the severity of student behavior and/or student or staff safety, please click here to apply for TRIAD behavior services:
https://redcap.link/behavior2223
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What type of administrative support do you feel like you have?
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What type of time commitment do you think you could make when working with TRIAD (i.e., hours per week, allotted time to view modules, time to consult with TRIAD, etc.)?
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Does your current role require you to provide professional development to others related to any of the topics you have indicated interest in above?
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Yes
No
In terms of classroom supports and resources, in the last 3 years do you have:
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More support than previously
Less support than previously
The same support I've been receiving
Type of Setting (Please check all that apply)
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What grade levels do you serve? (Check all that apply)
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I am filling this out for (Check all that apply):
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Is there a TRIAD professional development opportunity (PDO) that you have heard of that you want to hear more about? View our programs
here Yes No
Please choose the categories that you are interested in learning more about during your conversation with a TRIAD consultant in the near future (Check all that apply).
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Reading Services- please rate the level of your interest in this topic:
Educator Classwide Coaching and Support- please rate the level of your interest in this topic:
Administrator Training- please rate the level of your interest in this topic:
Early Childhood Focused Support and Coaching- please rate the level of your interest in this topic:
ParaEducator Opportunities- please rate the level of your interest in this topic:
Social and Personal Competencies- please rate the level of your interest in this topic:
Behavior Support and Coaching - please rate the level of your interest in this topic:
Communication Support and Services- please rate the level of your interest in this topic:
Academic Support and Coaching - please rate the level of your interest in this topic:
Middle-High School Transition Support - please rate the level of your interest in this topic:
Is there a training or service you are interested in that is not listed above?
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Yes No
What type of training format do you prefer? Please check all that apply.
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Group Learning-Please indicated preferred month(s) for this type of format (select all that apply):
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Individualized Learning-Please indicated preferred month(s) for this type of format (select all that apply):
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Hybrid-Please indicated preferred month(s) for this type of format (select all that apply):
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Please indicate which type(s) of group learning format you prefer. Check all that apply.
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Please indicate which type(s) of individualized learning format you prefer. Check all that apply.
Other format:
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