Introduction

This survey is designed to gather information about families experiencing the difficulties of estrangement.  The estrangement is generally between parents and their adult children (and grandchildren). The information collected is strictly anonymous and will help with the development of the book, I'm Still Your Grandma; I'm Still Your Grandpa, to be published in 2017.  Thank you in advance for your participation.  Claire N. Barnes, MA (www.myfavoriteteachersf.com) 

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* 1. Mark those categories which describe you best. Check all that apply.

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* 2. Describe the Adult Estranged Child(ren).  Check all that apply.

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* 3. In your opinion, what was the general cause of the estrangement? Check all that apply.

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* 4. How long has the estrangement lasted? Check all that apply.

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* 5. Do your best to rank the feelings you experience regarding your family estrangement. (1 is the easiest emotion to feel; 8 is the most difficult.)

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* 6. Are you estranged from your Grandchildren?

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* 7. Do you have any hope for a family reconciliation?

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* 8. What help do you have for family estrangement? 

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* 9. How do you spend special days (holidays, birthdays, etc.)?  Check all that apply.

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* 10. What advice do you have for newly Estranged Parents?

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