Screen Reader Mode Icon
Please complete this survey about your experience with your home visitor. Your responses will be kept confidential and separate from your contact information, if you choose to provide that. 

Question Title

* 1. What home visiting program are/were you enrolled in?

Question Title

* 2. My home visitor and I work well together.

Question Title

* 3. I feel comfortable talking with my home visitor.

Question Title

* 4. My home visitor listens to me. S/he does not tell me what to do.

Question Title

* 5. My home visitor communicates with me in a way that I understand.

Question Title

* 6. My home visitor gives me information that is useful to me. 

Question Title

* 7. My home visitor helps me figure out how to get the community resources that I need. 

Question Title

* 8. My home visitor respects my culture, values, and beliefs. 

Question Title

* 9. My home visitor is on time and comes for our regularly scheduled visits. 

Question Title

* 10. My home visitor makes me feel good about becoming/being a parent. 

Question Title

* 11. I would recommend this program to a friend. 

Question Title

* 12. What about this program has been the most helpful to you and your family? 

Question Title

* 13. What could be improved about this program? 

Question Title

* 14. If you choose to provide your contact information, your name will be entered into a drawing to win a gift card.

0 of 14 answered
 

T