IMPACTS 3.0 Parent / Caregiver Survey - 2023

Thank you for taking the time to provide us with feedback about your experience with the Clubhouse/Best Buy Teen Tech Center (we will refer to both as "Clubhouse" in this survey). Your responses will provide us with important information about how we can better work with you and your child.

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* 1. In which of the following cities is your child's Clubhouse located? (Please select from the dropdown menu)

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* 2. Please state the extent to which you agree or disagree with each of the following statements:

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
The Clubhouse helps me support my child to achieve their goals.	The Clubhouse helps me support my child to achieve their goals. Strongly disagree	The Clubhouse helps me support my child to achieve their goals. Disagree	The Clubhouse helps me support my child to achieve their goals. Neither agree nor disagree	The Clubhouse helps me support my child to achieve their goals. Agree	The Clubhouse helps me support my child to achieve their goals. Strongly agree
When my child has a challenge, I can use the Clubhouse as a resource.	When my child has a challenge, I can use the Clubhouse as a resource. Strongly disagree	When my child has a challenge, I can use the Clubhouse as a resource. Disagree	When my child has a challenge, I can use the Clubhouse as a resource. Neither agree nor disagree	When my child has a challenge, I can use the Clubhouse as a resource. Agree	When my child has a challenge, I can use the Clubhouse as a resource. Strongly agree
Together, the Clubhouse and I are making my child’s life better.	Together, the Clubhouse and I are making my child’s life better. Strongly disagree	Together, the Clubhouse and I are making my child’s life better. Disagree	Together, the Clubhouse and I are making my child’s life better. Neither agree nor disagree	Together, the Clubhouse and I are making my child’s life better. Agree	Together, the Clubhouse and I are making my child’s life better. Strongly agree
Thanks to support from the Clubhouse, I feel empowered to support my child.	Thanks to support from the Clubhouse, I feel empowered to support my child. Strongly disagree	Thanks to support from the Clubhouse, I feel empowered to support my child. Disagree	Thanks to support from the Clubhouse, I feel empowered to support my child. Neither agree nor disagree	Thanks to support from the Clubhouse, I feel empowered to support my child. Agree	Thanks to support from the Clubhouse, I feel empowered to support my child. Strongly agree

IMPACTS 3.0 Parent / Caregiver Survey - 2023

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* 1. In which of the following cities is your child's Clubhouse located? (Please select from the dropdown menu)

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* 2. Please state the extent to which you agree or disagree with each of the following statements:

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* 3. Please share an example or story of how the Clubhouse has helped you support your child.

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* 4. What improvements can we make to better support you and your child?

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* 5. Is there anything else you would like to add?