Shuswap Children's Association - Parent Survey 2010

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1. Please indicate what programs you have received or are receiving service from:

	Please check box
Infant Development Program	*Please indicate what programs you have received or are receiving service from: Infant Development Program Please check box
Supported Child Development Program	Supported Child Development Program Please check box
Occupational Therapy	Occupational Therapy Please check box
Physiotherapy	Physiotherapy Please check box
FASD Key Worker	FASD Key Worker Please check box
Respite Care	Respite Care Please check box
The Loft	The Loft Please check box
I DO NOT KNOW	I DO NOT KNOW Please check box

2. Do you feel that you receive enough visits/consultation/support from your consultant/therapist(s)?

	Yes	No	Not Applicable
Please choose one:	*Do you feel that you receive enough visits/consultation/support from your consultant/therapist(s)? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

3. Do you feel that our written feedback, information & assessments are helpful?

	Yes	No	Not Applicable
Please choose one:	*Do you feel that our written feedback, information & assessments are helpful? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

4. Do you feel like you are a partner in planning activities and goals for your child?

	Yes	No	Not Applicable
Please choose one:	*Do you feel like you are a partner in planning activities and goals for your child? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

5. Do you feel your consultant/therapist helps you to accept your child’s abilities and limitations?

	Yes	No	Not Applicable
Please choose one:	*Do you feel your consultant/therapist helps you to accept your child’s abilities and limitations? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

6. Do you feel that SCA keeps your information confidential?

	Yes	No	Not Applicable
Please choose one:	*Do you feel that SCA keeps your information confidential? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

7. Are you aware that SCA has a resource library that you are welcome to use?

	Yes	No	Not Applicable
Please choose one:	*Are you aware that SCA has a resource library that you are welcome to use? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

8. Through your consultant/therapist, do you feel that you know more about community services available for your child and yourself?

	Yes	No	Not Applicable
Please choose one:	*Through your consultant/therapist, do you feel that you know more about community services available for your child and yourself? Please choose one: Yes	Please choose one: No	Please choose one: Not Applicable

Comments

9. Do you have any additional comments for our staff?

Do you have any additional comments for our staff?

10. Are you interested in learning more about our Program Advisory Committees or SCA’s Board of Directors?

	Yes	No	Not at this time but keep me in mind for the future
Please choose one:	*Are you interested in learning more about our Program Advisory Committees or SCA’s Board of Directors? Please choose one: Yes	Please choose one: No	Please choose one: Not at this time but keep me in mind for the future

Comments