RiverBend Kids Play - Needs Survey

100% of survey complete.

Thank you for taking the time to complete this survey, focused upon the potential development of an on-site drop-in childcare center at RiverBend. All of the questions are optional, please feel free to answer only those questions that you are comfortable answering. This information will be used for research purposes and to aid us in securing support for our concept. Your information will not be sold or used in any other manner.

* 1. Are you male or female?

* 2. In what city do you live?

* 3. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

* 4. What is your age?

* 5. How many children, by age, currently live in your household?

* 6. Has a lack of childcare resources ever been an obstacle to your ability to access healthcare?

* 7. Arranging childcare so that I or my family members can attend medical appointments or support services is a challenge for me.

* 8. Have you or a family member ever had to miss or reschedule a medical appointment or support service appointment due to a lack of childcare resources?

* 9. Have you ever used drop-in chldcare services?

* 10. If yes, have you used drop-in childcare services in the past...

* 11. If yes, where? (check all that apply)

* 12. If yes, now frequently?

* 13. Would you use a drop-in childcare center at RiverBend while visiting the doctor, receiving treatment, or visiting/supporting a patient?

* 14. If yes, when? (check all that may apply)

* 15. Would other services at the childcare center be important to you, such as:

* 16. How much are you willing to pay for this service for one child per hour? (you may check more than one)

* 17. Given the choice between two medical service complexes, would you be more likely to seek service from a medical complex that offered on-site drop-in childcare?

* 18. Which hospital/medical center does your family most often frequent?

* 19. What determines where you receive your medical care? (answer all that apply)

* 20. Please use this space for feedback, comments and suggestions.

* 21. Would you be willing to answer further questions about your needs as we develop our concept? If so, please provide your name and preferred contact information. (NOTE: we will not sell your information, if will be used for our research purposes only)

* 22. Would you like to receive e-mail updates about RiverBend Kids Play? If so, please enter your e-mail address here.

Thank you for taking the time to complete this survey. all responders, who have given us contact information (in either question 21 or 22 above), will be entered into a drawing for one of three $10 Cafe Yumm gift cards.