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* 1. Which Parent Child Center have you been involved with?

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* 2. Was this survey completed with the assistance of an interpreter?

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* 3. How long has your family been involved with the Parent Child Center?

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* 4. How did you hear about this Parent Child Center?

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* 5. My family has participated in the following Parent Child Center services (check all that apply):

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* 6. In the last 6 months have you or anyone in your family struggled with any of the following issues (check all that apply):

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* 7. Support with issues

  Not at all Somewhat A lot
Did the Parent Child Center support your family with any of the above issues in the past 6 months?
Please tell us how you felt before you received Parent Child Center services/supports and how you feel today.

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* 8. I have relationships with people who provide me with support when I need it.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 9. I know where to go in the community when I need help.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
My answer today

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* 10. I feel strong and confident as a parent.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 11. I feel able to handle stressful events.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 12. When I am worried about my child, I have someone to talk with.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 13. Usually, my child expresses his/her feelings appropriately.

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 14. I take good care of my child(ren) even when I have personal problems

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 15. I manage the daily responsibilities of being a parent/caregiver

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 16. I understand my child(ren)'s development

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 17. I know where I can get helpful information about parenting and taking care of children

  Always Mostly Sometimes Rarely Never
Before I received services/supports
Today

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* 18. Please share any other comments about your experience with the Parent Child Center:

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