Connecticut Family Support Network Survey Question Title * 1. How did you hear about the Connecticut Family Support Network (CTFSN)? Question Title * 2. Was the CTFSN responsive to your needs? Yes No Comments: Question Title * 3. How helpful was the information you received from CTFSN? Extremely Helpful Very Helpful Helpful Somewhat Helpful Not At All Helpful Did Not Receive Information Please Rate: Please Rate: Extremely Helpful Please Rate: Very Helpful Please Rate: Helpful Please Rate: Somewhat Helpful Please Rate: Not At All Helpful Please Rate: Did Not Receive Information What information was most helpful to you? Question Title * 4. How likely are you to contact CTFSN in the future? Extremely Likely Very Likely Likely Somewhat Likely Not At All Likely Please rate: Please rate: Extremely Likely Please rate: Very Likely Please rate: Likely Please rate: Somewhat Likely Please rate: Not At All Likely Why? Or why not? Question Title * 5. How do you communicate with the CTFSN? (Please respond for all of the formats you have used.) Most Often Sometimes Rarely Have Not Used Phone Phone Most Often Phone Sometimes Phone Rarely Phone Have Not Used Email Email Most Often Email Sometimes Email Rarely Email Have Not Used Facebook Facebook Most Often Facebook Sometimes Facebook Rarely Facebook Have Not Used Website (www.ctfsn.org) Website (www.ctfsn.org) Most Often Website (www.ctfsn.org) Sometimes Website (www.ctfsn.org) Rarely Website (www.ctfsn.org) Have Not Used Comments: Question Title * 6. Would you like to be added to the CTFSN email list? If yes, please provide your email and town. You will receive information about resources and programs for families with children with special needs. Email Town Question Title * 7. If you would like a CTFSN Regional Coordinator to contact you, please provide the following: Name: Child's Age: Address: City: State: Zipcode: Email: Phone: Done