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* 1. What is your gender?

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* 2. What is your age? 

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* 3. Are you married

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* 4. Do you have children

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* 5. How many children are currently residing in your home?

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* 6. Do you receive government benefits (ex. SNAP, WIC, SS, Unemployment, Medicare/cade) 

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* 7. Have you ever taken a parenting class? 

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* 8. Who do you think is responsible for preventing child maltreatment?

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* 9. I believe people in our community need parenting support.

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* 10. I believe I need parenting support.

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* 11. I believe all parents in our community deserve support.

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* 12. I believe people should take advantage of parenting support in our community.

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* 13. I believe I should take advantage of parenting support in our community.

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* 14. I believe there should be more funding for preventing child maltreatment in Montezuma County.

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* 15. I believe there should be more funding for parenting programs in Montezuma County.

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* 16. I believe I play a role preventing child maltreatment.

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* 17. It's ok to ask for help with parenting.

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* 18. I believe child maltreatment is preventable.

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* 19. I think there needs to be more policy to prevent child maltreatment.

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* 20. I think there needs to be more funding to prevent child maltreatment.

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* 21. I think parents should be trained in preventing child maltreatment

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* 22. Most adults in my community believe they play a role in preventing child maltreatment.

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* 23. I have accurate information about child maltreatment in my community.

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* 24. Most adults in my community have accurate information about child maltreatment.

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* 25. I support kids in my community.

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* 26. Other people support kids in my community.

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* 27. If I saw a child being maltreated I would intervene.

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* 28. I think my neighbor/ co-worker/ friend would intervene if they saw a child being maltreated.

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* 29. I believe physically punishing a child is not necessary because there are other ways to discipline a child.

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* 30. Most adults in my community believe physically punishing a child is not necessary because there are other ways to discipline a child.

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* 31. I believe it is important my child never experiences child maltreatment.

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* 32. I believe most parents think it’s important their children never experience maltreatment.

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* 33. I have heard of the Child Maltreatment Prevention Action Team (CMPAT)

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* 34. I know how to prevent child maltreatment.

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* 35. Most people in the community know how to prevent child maltreatment

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* 36. Copy and paste this link into your browser to enter to win a gift card: https://forms.gle/xzEebYUmkdw8F8B97

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