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Surveys

We are using surveys to help us evaluate the outcomes of the grant. Please complete the following surveys only if Sue Redepenning or an AT consultant has requested that you do so. The surveys are hosted by SurveyMonkey and will open in a new window or tab after clicking on the title.

Participants

Please complete this survey immediately following a case consultation if you received a consultation or were present for a case consultation: AT Assessment Satisfaction Survey (v2.4).

Counties and Tribes

Please complete this survey if you are a county or tribe worker who referred an individual who is eligible for a case consultation: County / Tribe Intake Survey (v2.1).

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Referrals

To submit a referral, download the following form:
Download Referral Form (updated 04/07/2019)

Then upload it here:
Submit files securely

If you would like a copy of our HIPAA Statement for your records, you can get a copy here:
Download HIPAA Statement

Commissioner’s Circle of Excellence Award 2014
AT Consultant Schedule
July 19, 2019
  • Worthington- Nobles Co.
July 20, 2019
  • St Cloud- Sherburne Co.
July 22, 2019
  • Eden Prairie- Hennepin Co.
  • Blaine - Anoka Co.
July 24, 2019
  • Waseca- Waseca Co.
  • Maplewood- Ramsey Co.
  • Brooklyn Center & Hopkins- Hennepin Co.
  • Mendota Heights- Dakota Co.
  • Minnetonka- Hennepin Co.
July 25, 2019
  • Anoka- Anoka Co.
July 29, 2019
  • Bloomington - Hennepin Co.
July 30, 2019
  • North Mankato - Nicollet Co
  • St. Peter, MN - Nicollet Co.
July 31, 2019
  • Hopkins- Hennepin Co.
August 1, 2019
  • Lake George- Hubbard Co.