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* 1. Overall, how satisfied are you with the childcare received within the respite program?

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* 2. How satisfied were you with the application process to receive respite care?

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* 3. Are you satisfied with the amount of time your child spends in respite care?

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* 4. On a scale of one to five, how much does your child enjoy the respite program?

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* 5. How old is your child? (please select all that apply)

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* 6. How long has your child been attending the respite program?

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* 7. Have you visited the Apple Blossom Day Homes website before?

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* 8. What supports and/or services are you accessing while utilizing respite care?

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* 9. Is there anything you would like to change about the respite program?

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* 10. Do you have any comments, questions, or concerns?

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