PAT Parent Satisfaction Survey

To help us make our program the best it can be, please complete this short survey by circling the number that best describes your experience (1=Strongly Disagree; 2=Disagree 3=Neither Agree nor Disagree; 4=Agree; 5=Strongly Agree). Your responses will be kept private. Thank you!

Question Title

* 1. Are you the childs:

Mother

Father

Other (please specify)

Question Title

* 2. I feel

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
comfortable talking with my parent educator.	comfortable talking with my parent educator. Strongly Disagree	comfortable talking with my parent educator. Disagree	comfortable talking with my parent educator. Neither Agree nor Disagree	comfortable talking with my parent educator. Agree	comfortable talking with my parent educator. Strongly Agree

Question Title

* 3. My parent educator

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
is genuinely interested in me and my child.	is genuinely interested in me and my child. Strongly Disagree	is genuinely interested in me and my child. Disagree	is genuinely interested in me and my child. Neither Agree nor Disagree	is genuinely interested in me and my child. Agree	is genuinely interested in me and my child. Strongly Agree

Question Title

* 4. Activities

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
in the visits strengthen my relationship with my child.	in the visits strengthen my relationship with my child. Strongly Disagree	in the visits strengthen my relationship with my child. Disagree	in the visits strengthen my relationship with my child. Neither Agree nor Disagree	in the visits strengthen my relationship with my child. Agree	in the visits strengthen my relationship with my child. Strongly Agree

Question Title

* 5. My parent educator

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
encourages me to read books to my child.	encourages me to read books to my child. Strongly Disagree	encourages me to read books to my child. Disagree	encourages me to read books to my child. Neither Agree nor Disagree	encourages me to read books to my child. Agree	encourages me to read books to my child. Strongly Agree

Question Title

* 6. My parent educator

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
and I partner to set goals for my child, myself and my family.	and I partner to set goals for my child, myself and my family. Strongly Disagree	and I partner to set goals for my child, myself and my family. Disagree	and I partner to set goals for my child, myself and my family. Neither Agree nor Disagree	and I partner to set goals for my child, myself and my family. Agree	and I partner to set goals for my child, myself and my family. Strongly Agree

Question Title

* 7. My parent educator

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
helps me find useful resources in my community.	helps me find useful resources in my community. Strongly Disagree	helps me find useful resources in my community. Disagree	helps me find useful resources in my community. Neither Agree nor Disagree	helps me find useful resources in my community. Agree	helps me find useful resources in my community. Strongly Agree

Question Title

* 8. My parent educator

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
gives me handouts that help me continue learning about parenting and child development.	gives me handouts that help me continue learning about parenting and child development. Strongly Disagree	gives me handouts that help me continue learning about parenting and child development. Disagree	gives me handouts that help me continue learning about parenting and child development. Neither Agree nor Disagree	gives me handouts that help me continue learning about parenting and child development. Agree	gives me handouts that help me continue learning about parenting and child development. Strongly Agree

Question Title

* 9. This program

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
motivates me to try new parenting strategies.	motivates me to try new parenting strategies. Strongly Disagree	motivates me to try new parenting strategies. Disagree	motivates me to try new parenting strategies. Neither Agree nor Disagree	motivates me to try new parenting strategies. Agree	motivates me to try new parenting strategies. Strongly Agree

Question Title

* 10. This program

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
increases my understanding of my child’s development.	increases my understanding of my child’s development. Strongly Disagree	increases my understanding of my child’s development. Disagree	increases my understanding of my child’s development. Neither Agree nor Disagree	increases my understanding of my child’s development. Agree	increases my understanding of my child’s development. Strongly Agree

Question Title

* 11. This program

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
helps me build relationships with other families.	helps me build relationships with other families. Strongly Disagree	helps me build relationships with other families. Disagree	helps me build relationships with other families. Neither Agree nor Disagree	helps me build relationships with other families. Agree	helps me build relationships with other families. Strongly Agree

Question Title

* 12. I feel

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
less stressed because of this program.	less stressed because of this program. Strongly Disagree	less stressed because of this program. Disagree	less stressed because of this program. Neither Agree nor Disagree	less stressed because of this program. Agree	less stressed because of this program. Strongly Agree

Question Title

* 13. I am

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
very satisfied with this program.	very satisfied with this program. Strongly Disagree	very satisfied with this program. Disagree	very satisfied with this program. Neither Agree nor Disagree	very satisfied with this program. Agree	very satisfied with this program. Strongly Agree

Question Title

* 14. I would

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
recommend this program to a friend.	recommend this program to a friend. Strongly Disagree	recommend this program to a friend. Disagree	recommend this program to a friend. Neither Agree nor Disagree	recommend this program to a friend. Agree	recommend this program to a friend. Strongly Agree

PAT Parent Satisfaction Survey

Question Title

* 1. Are you the childs:

Question Title

* 2. I feel

Question Title

* 3. My parent educator

Question Title

* 4. Activities

Question Title

* 5. My parent educator

Question Title

* 6. My parent educator

Question Title

* 7. My parent educator

Question Title

* 8. My parent educator

Question Title

* 9. This program

Question Title

* 10. This program

Question Title

* 11. This program

Question Title

* 12. I feel

Question Title

* 13. I am

Question Title

* 14. I would

Question Title

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

Question Title

* 16. What could be improved about this program?

Question Title

* 17. Additional Comments:

Question Title

* 18. Parent Educator Name (optional)

Question Title

* 19. Your Name (optional)