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Berrien County
Health Department


2149 E. Napier
Benton Harbor, MI 49022



Office Hours:
8:30am-5:00pm, Mon-Fri

Phone: (269) 926-7121
Email: bchd@bchdmi.org



BCHD Calendar
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For Children For Adults For Schools For Businesses For Providers

Triple P Provider Tools

For Triple P Providers: Please use the assessment tools below according to each unique level of intervention. Ensure that the client code is on each assessment and that the assessment tools are fully completed. You can find all other clinical tools you may need at www.triplep.org.

 

Please use the following Evaluation Guidelines to assist you in the completion of the required assessments.

 

Level of Intervention Assessment Tools Needed
Level 2 Selected Seminar

Seminar Attendance Sheet

Parent Satisfaction Survey

Triple P Referral Form

Level 2 Brief Primary Care

Encounter Tracking Form

Level 3 Primary Care

Encounter Tracking Form

Client Satisfaction Questionnaire

Level 3 Primary Care Stepping Stones

Encounter Tracking Form

Client Satisfaction Questionnaire

Level 3 Discussion Groups

Discussion Group Attendance Sheet

Discussion Group Satisfaction Questionnaire

Triple P Referral Form

Level 4 Group

Encounter Tracking Form

Client Satisfaction Questionnaire

Level 4 Standard

Encounter Tracking Form

Client Satisfaction Questionnaire

Level 5 Enhanced

Encounter Tracking Form

Client Satisfaction Questionnaire

Level 5 Pathways

Encounter Tracking Form

Client Satisfaction Questionnaire

 



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