TR Participant Parent/Guardian/Care-Taker Survey

We invite participant families, guardians, and care-takers who have been involved in Canton's Therapeutic Recreation program for 3 or more years to participate in this survey.

In an effort to better understand and serve our users, and in the hope of gathering data that may be instrumental in helping this program secure additional funding and support in the future, we are incredibly thankful for your time and willingness to complete this survey. Individual responses will remain anonymous and confidential.

Please submit your feedback by May 17, 2019. Thank you again!

Question Title

* 1. How long has your participant been active in Canton's Therapeutic Recreation program?

Less than 3 years

3-5 years

5-7 years

7-10 years

10+ years

Question Title

* 2. What is the current age of your participant?

under 15 years

15-18

19-24

25-30

31-35

36-40

41+

Question Title

* 3. Does your participant reside with you?

yes

sometimes

Question Title

* 4. Do you work outside the home?

Yes- I work full-time.

Yes- I work part-time.

No, I do not work.

Question Title

* 5. Please share the nature of your participant's disability. You may select more than one if needed.

Intellectual or Cognitive Disability

Emotional, Mood, or Psychiatric Disability

Autism Spectrum Disorder

Behavioral Impairment/Disability

Fetal Alcohol Syndrome Disorder

Brain Injury

Cerebral Palsy

Seizure Disorder or Neurological Impairment

Down Syndrome

Other

Question Title

* 6. How much help or assistance does your participant typically need with daily activities?

No Assistance needed

Some Assistance needed

Extensive Assistance needed

Question Title

* 7. Please indicate what services or supports are provided to your participant from the State.

Financial

In-home

Residential

Day or Employment Supports

Transportation

Other

Question Title

* 8. How valuable do you find Canton's TR program in providing respite or supervised care of your participant from a care-takers perspective? Please select the corresponding star.

It does not play a role in the routine for me/ our family/ my participant's care-takers.

It's a nice break, but not a necessity.

It is an important part of our routine for me/our family/my participant's care-takers.

It is a very important part of our routine for me/ our family/ my participant's care-takers.

It is an absolute necessity for me/our family/my participant's care-takers.

It does not play a role in the routine for me/ our family/ my participant's care-takers.

It's a nice break, but not a necessity.

It is an important part of our routine for me/our family/my participant's care-takers.

It is a very important part of our routine for me/ our family/ my participant's care-takers.

It is an absolute necessity for me/our family/my participant's care-takers.

Question Title

* 9. Outside of your participant's involvement in Canton's TR activities, how physically active would you consider his/her lifestyle?

Very Active

Moderately Active

Mildly Sedentary

Very Sedentary

Question Title

* 10. Do you feel like participation in Canton's TR activities increases your participant's activity level in a significant way?

Strongly Agree

Agree

Disagree

Strongly Disagree

Question Title

* 11. Based on their involvement in Canton's TR programs, camps, and classes, do you feel like your participant has:

Become more independent

Improved social skills

Formed new friendships

Identified positive role models in Canton TR staff

Further developed large motor skills

Improved their physical health

Improved their mental health

Further developed important life skills

Tried/Experienced new things

Question Title

* 12. Have you seen improvements in other areas that you'd be willing to share?

Question Title

* 13. Which programs/events/classes do you feel have most benefited your participant? Please share why.

Question Title

* 14. Are there ways that you think we can improve current offerings? Please share your thoughts or ideas.

Question Title

* 15. Do you think the program pricing fairly reflects the quality of current TR offerings?

Yes

TR Participant Parent/Guardian/Care-Taker Survey

Question Title

* 1. How long has your participant been active in Canton's Therapeutic Recreation program?

Question Title

* 2. What is the current age of your participant?

Question Title

* 3. Does your participant reside with you?

Question Title

* 4. Do you work outside the home?

Question Title

* 5. Please share the nature of your participant's disability. You may select more than one if needed.

Question Title

* 6. How much help or assistance does your participant typically need with daily activities?

Question Title

* 7. Please indicate what services or supports are provided to your participant from the State.

Question Title

* 8. How valuable do you find Canton's TR program in providing respite or supervised care of your participant from a care-takers perspective? Please select the corresponding star.

Question Title

* 9. Outside of your participant's involvement in Canton's TR activities, how physically active would you consider his/her lifestyle?

Question Title

* 10. Do you feel like participation in Canton's TR activities increases your participant's activity level in a significant way?

Question Title

* 11. Based on their involvement in Canton's TR programs, camps, and classes, do you feel like your participant has:

Question Title

* 12. Have you seen improvements in other areas that you'd be willing to share?

Question Title

* 13. Which programs/events/classes do you feel have most benefited your participant? Please share why.

Question Title

* 14. Are there ways that you think we can improve current offerings? Please share your thoughts or ideas.

Question Title

* 15. Do you think the program pricing fairly reflects the quality of current TR offerings?

Question Title

* 16. If you are not a resident of Canton, what motivates you to participate in a TR program outside of your home community?

Question Title

* 17. If Canton Therapeutic Recreation were to add new classes, programs, or services, what might you most like to see introduced?

Question Title

* 18. Is there anything else you would like to share with us?