* 1. Date

Date / Time
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* 2. Zipcode

* 3. Family Type

* 4. I feel that I am more knowledgeable of resources available to me.

* 5. When I worked with PAFC, the needs I presented were addressed. 

* 6. I feel comfortable returning to the Parma Collaborative if I need more assistance in the future. 

* 7. I felt that the meeting environment was safe and welcoming.  

* 8. I felt comfortable sharing my needs and concerns with the Parma Collaborative staff that I met.  

* 9. The staff understood my concerns and were non-judgmental.

* 10. My strengths(internal and external supports) were identified and respected.

* 11. I feel equipped to handle future problems on my own. 

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