Survey

Parent Information

First Name

Last Name

Phone

Please fill out the following:

When you reached out to Easterseals DC MD VA, did we answer all of your questions?

If no, please explain:

We noticed that you toured our center but have not enrolled. Why did you decide not to enroll your child at our center?

If you chose to enroll somewhere else, why?

If other, why?

By submitting this form I agree to receive information and tour reminder alerts via email and text message.