Family Satisfaction Survey

Dear Parents:
Every year we evaluate our program.  your input is very important to us.  Please help us by filling out this survey.  Your comments will be kept anonymous and confidential, so please respond honesty.

* 1. How long have you worked with a home visitor from Healthy Families?

* 2. Usually, how long are your visits with your home visitor?

* 3. Does your home visitor spend enough time with you?

* 4. How often does your home visitor talk with you about parenting your baby and your baby's health and development?

* 5. How often does your home visitor bring an activity for you to do with your child?

* 6. Have you and your home visitor talked about goals that you and your family wanted to work toward?

* 7. Has your home visitor offered to connect you with other agencies or programs that you are interested in?

* 8. I am more confident that I can do a good job of raising my child because I was a part of Healthy Families.

* 9. Does your home visitor speak clearly to you in a language you understand?

* 10. Does your home visitor provide materials (videos, handouts, fliers, and brochures) that represent your race, language, and ethnicity?

* 11. Does your home visitor respect and understand your family background?

* 12. Does your home visitor respect and understand your culture and beliefs?

* 13. Does your home visitor respect and understand your parenting style and the choices you make for your children?

* 14. Are the materials and information presented in a way that allow you to determine what is best for your child?

* 15. If you have attended any group gatherings, have you been satisfied with the group?

* 16. Which areas of your life have improved since beginning with Healthy Families (please mark all that apply)?

* 17. What would make Help Me Grow a better program for you?

* 18. Who is your home visitor?

Thank you for taking the time to answer these questions!

T