Simplified Child/Youth Feedback Survey

Question Title

* 1. Ask your youth if they are happy ( demonstrate a smiley face) or sad ( demonstrate a sad face) living here? Phrase the question in words that they best understand.

Very Happy 100

Moderately Happy 75

Non Reaction 50

Seemingly Unhappy 25

Very Unhappy 0

Question Title

* 2. Ask your youth if they are happy ( demonstrate a smiley face) or sad ( demonstrate a sad face) living here? Phrase the question in words that they best understand.

Sad reaction

Non reaction

Happy reaction

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 3. Ask your youth if they feel safe in words they best understand.
Answer Yes if the youth appears to agree with the statement
Anser No if the youth appears to disagree with the statement

Yes

No

No reaction

Question Title

* 4. Comment on anything you feel is relevant as feedback from your youth