Here are the worksheets, forms, data item definitions, and supporting resources for Parent Centers to use in submitting results of the 2016 Parent Center Data Collection activities and Program Measures Survey.  

This page gives Parent Centers the tools they need to collect and submit data on their Center’s activities  for the 2015-2016 program year (October 1, 2015 to September 30, 2016), as well as the results of the Program Measures Survey. A number of supporting materials are included throughout. A separate Frequently Asked Questions (FAQ) page is also available, and there is a schedule of drop-in call times for those who have questions or concerns to discuss.

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Part 1 Data Collection Forms, Definitions, and Where to Submit Your Data

Part 1 data collection refers to the number of contacts your Parent Center made via trainings and individual assistance in the 2015-2016 program year, the unduplicated parent count, descriptive disability data, and demographic data. To complete Part 1 of the data collection, use the forms and definition materials linked below.

Deadline for submission | November 4, 2016.

This year | The 2016 forms and definitions are virtually unchanged from last year’s.  The definition of “email contacts” has been revised, so that it now reads:

EMAILS/ TEXTS AND OTHER ELECTRONIC MODES | Count number of contacts using email or other electronic modes (e.g., text messages, Facebook messages, etc.) specifically for one-to-one individual assistance. Do not include mass e-mails that are for disseminating resources or for outreach activities.

Submit your Part 1 data using this Online Data Submission Form by November 4, 2016!

Supporting Materials

Read Sample Scenarios for Part 1 Data Collection 

Sample Script for Collecting Race/Ethnicity Data (in Word)
Information about the race/ethnicity of callers served by the Parent Center was added to the data collection forms last year.  The Sample Script (linked above) provides some language you might use in your Parent Center’s intake process, in order to collect that data. Please feel free to customize this script for use based on your data systems and intake/interview processes.

Listen to Webinar 1 explaining last year’s form 
(The 2016 form has only been altered slightly from last year’s form, so the explanation in this webinar is still on point.)

Download the Powerpoint Show on the Last Year’s Data Collection Form (1.5 MB)
Webinar 1 introduced the new data collection form premiered last year and discussed the new definitions key. The PowerPoint presentation is saved as a “show” so that it will launch automatically when you open the file.

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Part 2 Data Collection | Program Measures Survey: Why, How, and Where to Submit Results

Part 2 data collection refers to the Program Measures Survey, where your Center will ask a specific number of parents about their satisfaction with the information or services they received from your Center in the last 6 months of the 2015-2016 program year. Materials and resources available include: overview of Program Measures Survey on program performance for the year 2015-2016, instructions for completing, worksheets, survey forms in English and Spanish.

Deadline for submission | December 2, 2016

Overview of Part 2 data collection (online) | Also in Word

Instructions for Collecting and Submitting Your Data from the Program Measure Survey (online) | Also in Word

Program Measures Survey in English (in Word)

Program Measures Survey in Spanish (in Word)

Worksheet for Tallying Up Survey Results (in Word)

Submit your data using this Online Data Submission Form
(To be completed by Friday, December 2, 2016)

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Schedule of Drop-In Calls

Have questions about any or all of the above data collection and reporting activities? You’ll be pleased to know that several of the RPTACs will be holding drop-in calls and discussions to support Parent Centers in this year’s data collection. You are free to drop-in on any of these sessions, regardless of the region to which your Parent Center belongs.

Thursday, September 15 Drop-In Call
10 am Eastern | 9 am Central | 8 am Mountain | 7 am Pacific
Hosted by Region 1 RPTAC, NEPACT
Call-in number: 877-713-0446
Participant code: 389-654-6677

Wednesday, September 21 Drop-In Call
12 Eastern | 11 am Central |  10 am Mountain | 9 am Pacific
Hosted by Region 4 RPTAC, WI-FACETS
Register at:

Wednesday, October 5 Drop-In Call
5 pm Eastern | 4 pm Central | 3 pm Mountain | 2 pm Pacific
Hosted by Region 6 RPTAC, Matrix Parent Network
Attend at:
Call-in number:  877-512-6886
Conference ID: 655 481 7719

Thursday, October 20 Drop-In Call
2 pm Eastern | 1 pm Central |  12 pm Mountain | 11 am Pacific
Hosted by Region 5 RPTAC, PEAK Parent Center
Register at:

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