Directions: We want to know if WrapAround Service Coordination has been helpful to you. Check the box that matches what you believe about each statement. Skip any of the items you do not want to answer. All answers are kept confidential. If responses are shared, no identifying information will be included unless you express otherwise at the end of this survey. If you have any questions, please feel free to call Stacey Garske, Summit County Family and Children First Council Executive Director at 330-212-5508. Thank you for completing this survey! Your responses will help us build a stronger WrapAround Service Coordination program.

Question Title

* 1. Please identify your role on the Family Wraparound Service Coordination Team:

Question Title

* 2. Name of WrapAround Service Coordination Family Team Facilitator:

Question Title

* 3. The WrapAround process was explained and I understood my role on the family team

Question Title

* 4. I felt listened to and respected throughout the WrapAround process

Question Title

* 5. The family team was made up of both professionals and natural supports (for example, family members, friends, neighbors, pastor, etc.)

Question Title

* 6. The meetings were held at times and locations convenient to the family

Question Title

* 7. The meetings were helpful and productive

Question Title

* 8. Team meetings were scheduled as often as needed

Question Title

* 9. The Plan of Care developed by the Family Team included the Family’s Vision Statement and Team Mission Statement

Question Title

* 10. The Plan of Care developed by the Family Team had realistic action steps to help meet family vision and team mission/goals

Question Title

* 11. The Plan of Care was reviewed and updated at each meeting

Question Title

* 12. Team members completed assignments on time

Question Title

* 13. The youth/family were linked to appropriate community resources and supports

Question Title

* 14. Participating in WrapAround Service Coordination was a helpful experience and helped strengthen the youth/family

Question Title

* 15. The WrapAround Service Coordination Family Team Facilitator was effective; facilitated good team discussions and followed through on tasks

Question Title

* 16. Do have you any other comments and/or suggestions? Was there anything you needed but did not get?

Question Title

* 17. Name & Telephone number (optional)

Question Title

* 18. May we contact you with further questions?

T