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Parents and Caregivers for Wellness Survey

Greetings,

Parents and Caregivers for Wellness is a group of Parent/Caregiver run organizations from across California who are working together to improve behavioral health services and supports to children and their families. 

Families are the best resource we have to identify the strengths and needs of California’s families. To help us understand what behavioral health services and supports are needed in California, we are asking that you fill out the following survey.  The information you provide will help us develop training and advocacy activities.  

We hope that you will provide us with your name and contact information at the end of the survey so that we can send you the results of this survey, keep you updated on our activities, and provide you with information that will help you and your family.

If you have any questions about this survey or want to know more about us, please call (805) 384-1555, email mhannah@unitedparents.org or look us up on Facebook: https://www.facebook.com/ParentsAndCaregiversForWellness/ or our website: https://parentscaregivers4wellness.org/

Thank you for your time.

United Parents

Capital Adoptive Families Alliance

California Alliance of Caregivers

California Mental Health Advocates for Children and Youth

East Bay Children’s Law Offices
1.Which city do you live in?
2.Which county do you live in?
3.What is the age of the child in your home requiring/receiving mental health services?
4.What is your relationship to the child in your care? (check all that apply)
5.Which category best describes your child? (check all that apply)
6.What kinds of concerns do you have about the child/children you care for regarding their physical/neurological health?  (check all that apply)
7.What kinds of concerns do you have about the child/children you care for regarding their mental health?  (check all that apply)
8.What kinds of concerns do you have about the child/children you care for regarding their behaviors?  (check all that apply)
9.Do you believe the physical, neurological, mental health and/or behavioral challenges are because of trauma?
10.Are you receiving all of the services and supports you need for the child or youth you care for?
11.If you answered “no” or “don’t know” to the question above, what services are you missing for your child? (check all that apply)
12.If you answered “no” or “don’t know” to the question above, why are you missing services? (check all that apply)
13.Are you receiving all of the services and supports you need for yourself?
14.If you answered “no” or “don’t know” to the question above, what services are you missing? (check all that apply)
15.If you answered “no” or “don’t know” to the question above, why are you missing services? (check all that apply)
16.How do you find out about community resources and supports? (check all that apply)
17.What additional information and training/classes do you need? (check all that apply)
18.What is the best day/time for you to attend a training? (check all that apply) 
19.Which local agencies or individuals need to be trained about the needs of you and the child or youth you care for? (check all that apply)
20.If you could advocate for anything for you/your child, what would it be?
21.If you would like to be contacted regarding events that may interest you or provide you with resources you/your child need: