PAT FORMS
What form is completed in preparation for your visit on paper or Visit Tracker?
Personal Visit Planning Guide
When PAT affiliates actively foster connections with a variety of community organizations that meet a family's needs and interests.
Resource Connection
Form used or completed in VT to prepare for a Group Connection
Group Connection Planning Guide
A developmental screening used in the Parents as Teachers programs.
ASQs
How many Foundational Visits are there?
8
In O.L.I.V.E.R. under which two WORKSPACES can parent educators access the commonly used forms?
Model Implementation-->PAT Records
Foundational -->Fillable Forms
In the Resource Connection Record Instructions, it states that a resource connection should be updated at least _____________ .
Monthly
What form is completed by participants that will help your PAT program when planning group connections in the future.
Group Connection Feedback Form
Under PAT Records what is the name of the document used to document goals (paper version)?
Goal Record
What forms are used to prepare for a personal visit?
Foundational Personal Visit Plan or Personal Visit Planning Guide and Personal Visit Record
A form that is reviewed, discussed, and signed with the family by the end of the first Foundational visit relating to services and expectations of the PAT Program.
Participation Agreement and Consent for Services
*Not required to use the PAT version, but must use a participation agreement and consent for services.
Under the Essential Requirements at least how many resource connections should be documented for an enrolled family in a program year?
At least 1
How many group connections should be completed through out the year to meet ER #14.
How many families need to attend a meeting/event to be counted as a group connection?
12
1
This lists the skills and behaviors that children are developing. You are expected to review before your visit and document any newly emerging or achieved milestones after your visit.
PAT Milestones
*Affiliates can opt to use the CDC Milestones in place of the PAT Milestones.
What needs to be completed in Visit Tracker within 3 working days after your personal visit.
Personal Visit Record = PVR
Which forms is completed or printed once the family plans to exit the PAT Program? (Visit Tracker Reports)
1. Transition Plan (w/in 30 days)
2. Family Service Record & Exit Summary
(VT = Service Record & Child Exit Report)
In visit tracker which side tab is used to document when connecting a family to an organization to try to meet a family's needs?
Resource Connection
What form do you complete in Visit Tracker that should be completed no more than three workdays after each group connection?
Group Connection Record
Which assessment(s) can a parent educator use to assist in creating a goal for the family?
LSP - Life Skills Progression
ASQ
What are the 3 Roles of a Parent Educator during a personal visit?
Reflecting, Partnering, Facilitating
The form that program participants can complete and will help us make our program the best it can be.
Parent Satisfaction Survey
*Not required to use the PAT version; affiliates can use a different satisfaction survey.
Which form is completed when a Parent Educator would like to share that family's info with an organization for assistance?
Permission to Exchange Information
*Not required to use the PAT version, but must use a permission to exchange information form before releasing family information.
What form is available to all Parent Educators under O.L.I.V.E.R. -> Foundational -> Fillable Forms as a guide when creating a Group Connection?
Group Connection Preparation Checklist
Child health review is completed within ____ days of enrollment or the child’s birth
90
T or F: Can foundational visits 1-8 be repeated or completed in a different order?
True