Survey #12

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* 1. Please choose the best answer for each statement:

  Strongly disagree Disagree Agree Strongly agree Does not apply. My child has not needed an appointment/care/tests/treatment
I am able to get an appointment for my foster child for a routine checkup at a doctor's office or clinic as soon as I need one.
I am able to get my foster child an appointment to see a specialist as soon as I need one.
It is easy to get the care, tests, or treatment my foster child needs.

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* 2. Please choose the best answer for the following statements:

  Strongly disagree Disagree Agree Strongly agree Does not apply.  I have not called Passport.
Passport connects my foster child to programs or providers who can help him or her be healthier and have a better quality of life.
When I call Passport, I get the information or help I need.

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* 3. Please provide any comments related to your answers to the questions above:

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* 4. If you would like more information about any of the following, please check all that apply:

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* 5. If there is a specific problem that Passport can help you with, please explain:

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* 6. Please include any other comments or questions:

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* 7. If you'd like more information or help, please provide your contact information  You can also call us at 1-800-578-0603 and ask for the Foster Care Team.

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