NOFAS Resource Directory Survey

50% of survey complete.

Win a $50 Target or Amazon.com Gift Card!

Complete this short survey about your visit to the NOFAS Resource Directory and be entered into a monthly drawing to win a $50 Target or Amazon.com gift card (your choice!).

Question Title

* 1. How did you locate NOFAS?


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* 2. Please specify what you are seeking from NOFAS? (Choose all applicable resources)

Diagnostic services

Counseling or therapy for an individual with an FASD

Housing or residential care for an individual with an FASD

Legal advocacy

Education advocacy

Support Groups

Prevention programs

Addiction treatment services for women

FASD State Coordinator

NOFAS Affiliate

Circle of Hope/Birth Mother's Network contact

Other (please specify)

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* 3. What best describes you?


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* 4. Please rate your overall satisfaction with NOFAS's handling of your resource inquiry.

	Very Satisfied	Somewhat Satisfied	Neither Satisfied or Dissatisfied	Somewhat Dissatisfied	Very Dissatisfied
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Comment

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* 5. To be qualified for the $50 Target or Amazon.com gift card drawing, you must complete the following:

First Name

Last Name

State

Email Address

Your name and email address will not be used for any purpose other than the gift card drawing and it will not be shared with or sold to any entity or individual.