2026 Caregiver Needs Assessment Survey

Thank you for taking this survey. The results of this survey inform our programming and supports we provide to the community. The information you share will be anonymous. Everyone who completes all required questions will have the option at the end of the survey to enter a raffle for one of four prizes: one SAMi Camera or one of three Mightier devices.

Deadline to Submit: December 15th
Estimated Completion Time: 10 minutes
Raffle winners will be notified via email by December 20th

Disclaimer:
The devices included in this raffle are provided "as is." The Child Neurology Foundation does not manufacture, endorse, or guarantee the performance, accuracy, or reliability of these devices. They should not be considered a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified healthcare provider regarding any medical concerns. By accepting a device, the winner assumes full responsibility for its use. The Child Neurology Foundation disclaims any and all liability arising from the use or misuse of these devices.

Thank you to our sponsor.

1.Are you a parent or main caregiver of a child with a disability? Your child can be any age, including an adult.(Required.)

Yes

2.Where is your family on this journey right now? Pick the one that fits best.(Required.)

My child was recently diagnosed

My child is young, and we have settled into a routine

My child is in school, and we are handling day-to-day life

We are starting to think about the teen years

We are in the middle of moving to adult care

I care for an adult child

4.Does your child have epilepsy or seizures?(Required.)

Yes

Not sure

5.What is your child's main diagnosis? You can skip this if you are not sure or would rather not say.