You are filling out the following survey to learn if your infant’s social and language skills will qualify him or her for an In-Home Social Jumpstart Program offered through UCSB!
In addition to providing information about your infant’s social and communication behavior, you will be asked to provide some necessary identifying information so that we can contact you with the results of the survey.
We will do our best to keep your information confidential. All data is stored in a password protected electronic format. However, absolute confidentiality cannot be guaranteed.
ELECTRONIC CONSENT: Please select your choice below.
If you agree to fill out this survey, click “agree” below: