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SDB Parent Survey
1.
Please check the box to indicate your level of agreement for each of the below statements.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My son's treatment needs are being met.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My son's medical needs are being met.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My son's emotional needs are being met.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My son's educational needs are being met.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
2.
My son's service plan addresses the appropriate behavioral needs.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
3.
I believe my son is safe in the program.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
4.
I am treated with respect.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
5.
My voice is heard by service providers.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
6.
I am pleased with the amount of contact I receive from my Case Worker.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
7.
This service is helping me to understand my son better
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
8.
I am learning new ways to respond to my son's needs.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
9.
My child’s Case Worker makes attempts to engage me in my child’s treatment.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
10.
I believe the services my son receives will have a positive impact on his future.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
11.
Please indicate your level of agreement with the below statements. If you are not participating in the service, check N/A
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Family BHIS is preparing us for my son's transition to reunification.
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Family Therapy is preparing us for my son's transition to reunification.
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Integrated Health Home (IHH) is preparing us for my son's transition to reunification.
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
12.
My family has weekly in-person or virtual visits.
Yes
No
13.
When my child is home for visits, we are receiving the support we need.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
14.
If you are not receiving the support needed when your child has home visits, please provide any feedback on what is needed to assist in successful home visits.
15.
When my child is home for visits the safety planning interventions are being followed from the family interaction plan.
Always
Usually
Sometimes
Rarely
Never
16.
I need assistance in the following areas
Medical
Mental Health
Housing/utilities
Employment
Food
Transportation
Other (please specify)
17.
Please enter any additional comments, concerns, or suggestions.