Tell Us How We Can Help you deal with Autism, ADD and ADHD Question Title * 1. Are you caring for someone with Autism, ADD or ADHD ? Autism ADD ADHD All of the Above Other (please specify) Question Title * 2. What problems are most difficult for you as a Caregiver to manage on a daily basis? Worry and Anxiety Overwhelm Fear Frustration Managing Time Other (please specify) Question Title * 3. What kind of care would be most helpful for you at present? Someone to talk with weekly Help to deal with the problems of the disease Personal help for the child or adult with the illness A new strategy for dealing with the difficulties day to day Other (please specify) Question Title * 4. Are you willing to seek Alternative Healthcare to help you deal with the problems of Autism, ADD and ADHD? Yes No Would Consider Alternative Healthcare I have Questions Other (please specify) Question Title * 5. How much time do you expect it will take to see results with an Alternative, Holistic Plan to help your loved one who has complications of Autism, ADD or ADHD? 3 Months 6 Months 9 Months 1 Year 2 years or More Other (please specify) Question Title * 6. What are you presently paying for the health care of your loved one with Autism, ADD or ADHD? $100 per month $300 per month $500 per month Healthcare is provided at no cost to me Much more than listed above Other (please specify) Done