We are researching how to support parents of adolescents and adults with autism spectrum disorder (ASD). As part of this research, we are holding a free, web-based mindfulness group for parents of adolescents and adults with ASD to help them cope. If you think this is something you might be interested in learning more about, please complete this short survey.

* 1. Name 

* 2. Mailing Address 

* 3. Email Address 

* 4. Telephone Number 

* 5. How do you prefer to be contacted? 

* 6. Do you have a child with ASD who is 16 or older?

* 7. Do you have access to a phone?

* 8. Do you have access to a tablet or computer with internet? 

* 9. Do you have access to a web camera? Or a computer with a built-in camera? 

* 10. Do you have access to earbud headphones with a microphone? 

* 11. Have you previously participated in a mindfulness-based program? 

* 12. Have you previously participated in parent support groups? 

* 13. The groups will run for 6 weeks on Tuesdays from 12:30-2pm. The dates will be: April 4th, April 11th, April 18th, April 25th, May 2nd and May 9th. Are you available on these dates/at this time?

Thank you for completing this survey. Someone from the project team will contact you shortly. In the meantime, if you have further questions or would like more information, please contact Michelle at: michelle.dale@camh.ca OR 416-535-8501 x37819
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