I am the:

Question Title

* 1. I am the:

Parenting Time Center I use:

Question Title

* 2. Parenting Time Center I use:

Service I have used at the Parenting Time Center

Question Title

* 3. Service I have used at the Parenting Time Center

Amount of time utilizing Parenting Time Center:

Question Title

* 4. Amount of time utilizing Parenting Time Center:

Parenting Time has benefited me in the following ways (please check all that apply):

Question Title

* 5. Parenting Time has benefited me in the following ways (please check all that apply):

Parenting Time Center has benefited my child(ren) the following ways (please check all that apply)

Question Title

* 6. Parenting Time Center has benefited my child(ren) the following ways (please check all that apply)

Please rate Parenting Time Center on the following:


 Friendly:

Question Title

* 7. Please rate Parenting Time Center on the following:


 Friendly:

Helpful:

Question Title

* 8. Helpful:

Knowledgeable:

Question Title

* 9. Knowledgeable:

Unbiased:

Question Title

* 10. Unbiased:

Respectful:

Question Title

* 11. Respectful:

What did you find most helpful about the services you and your child(ren) received:

Question Title

* 12. What did you find most helpful about the services you and your child(ren) received:

Is there additional information that you or your child(ren) would have liked to receive?

Question Title

* 13. Is there additional information that you or your child(ren) would have liked to receive?

Are there additional services that you or your child(ren) would have liked to receive?

Question Title

* 14. Are there additional services that you or your child(ren) would have liked to receive?

How would you improve the services that you or your child(ren) received?

Question Title

* 15. How would you improve the services that you or your child(ren) received?

If Someplace Safe had $100,000 what would you recommend is done with the money?

Question Title

* 16. If Someplace Safe had $100,000 what would you recommend is done with the money?

Please share with us any other comments you have about your experiences at the Parenting Time Center:

Question Title

* 17. Please share with us any other comments you have about your experiences at the Parenting Time Center:

T