WELCOME ...

You have arrived at the October 2012 Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) Caregiver Needs Assessment Survey.

We invite you to complete this Survey if you provide care for a child, a family member or a friend who has mental health or substance abuse treatment needs.

Your opinion and experience are important and will help us improve services across the State of Tennessee.

Only adults should complete this Survey. An adult is someone who is 18 years of age or older.

The Survey consists of 24 questions and completion of the Survey takes about 15 minutes.

While we encourage you to complete the entire Survey, you may stop at any time. The answers you have given up to that point will be included in our information analysis. Results from the analysis (of this Survey) will be given to the Regional and State Planning and Policy Councils. The Councils will use this information to make recommendations for changes to the services that are available in each community and to ensure that needs are met as much as possible.

The following is important information you will need to know before you begin:

1. You may complete the survey for your child. A child is someone who is under 18 years old. Your child could be your birth child, a foster child, adopted child, step child, or a child who is not related to you by blood but who you consider your child.
2. You can complete this Survey for another adult for whom you provide care. That adult can be a family member, a spouse, or someone who is not related to you by blood but who you consider to be your family member. Any of the individuals mentioned in this item (2) are considered to be a family member for this Survey.
3. If you provide care for more than one person who has mental health or substance abuse treatment needs, you may complete the Survey for each of those persons or only one of them.
4. Your participation is voluntary.
5. No one will be able to connect your answers to you.

The Department of Mental Health and Substance Abuse Services is very interested in your opinion.

Thank you for your participation.

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