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1. My Child Probably Needs Help

This is an anonymous research survey not intended to be published but just to help build information for a proposal to fund a process that might actually help prepare young people for adulthood.  We feel that there has not been enough to address the needs of our young people and we feel we may have a solution.  Please help us by answering a few questions that will help shape the type of care that is used to address the issue. 

Please be aware that this survey asks some sensitive questions that you may find offensive as a parent or guardian.  I offer an apology and understand why you might want to leave the survey now.  

If you are a parent or guardian interested in learning more about the proposal that is prompting this survey, please contact Angela Hamann at 907-980-8949.

Thank you, Angela Hamann
DEMOGRAPHICS

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* 1. What is your gender?

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* 2. Which race/ethnicity best describes you? (Please choose only one.)

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* 3. Which of the following categories best describes your employment status?

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* 4. What is the highest level of school you have completed or the highest degree you have received?

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* 5. Do you identify with any of the following religions? (Please select all that apply.)

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* 6. In what year were you born? (enter 4-digit birth year; for example, 1976)

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