Participant Survey

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About
Our Parenting Programmes
Facilitators
Mentors
Counsellors
Fundraising
- Donate Now
Volunteer Opportunities
Contact

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Participant Survey

Participant Survey

Name or ID:

Date:

Please circle the number that best describes how much you agree or disagree with the statement.

1. Meeting with a group of parents was helpful to me. 12345 2. The leader did a good job working with my group. 12345

Please rate the following statements BEFORE and NOW completing the Circle of Security Parenting class.

3. My level of stress about parenting is high

BEFORE 12345

NOW 12345

4. I have a positive relationship with my child(ren)

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

5. I recognize the behaviors that trigger my negative response to my child

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

6. I identify and respond to my child’s needs for support and comfort

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

7. When I fail to respond to my child’s needs, I try to repair the relationship

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

8. I think about what my child’s behavior is telling me

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

9. I feel confident I can meet the needs of my child(ren)

BEFORE 1 2 3 4 5

NOW 1 2 3 4 5

10. Is there anything else you'd like to share? 11. Why did you decide to enroll in COSP? 12. How did you hear about COSP? (Check all that apply) FriendTherapistChildcare providerCourt SystemSchool/Head StartPrint or Social MediaOther If Other: 13. Gender Identity malefemalenon-conformingother If Other: 14. Ethnicity Hispanic/LatinoNot Hispanic or Latino 15. Race (Check all that apply) American Indian or Alaska NativeAsianBlack or African AmericanWhiteNative Hawaiian or Other Pacific IslanderOther If Other: 16. Are you a military family? yesno 17. How many children do you have? 18. Ages of your child(ren) (Check all that apply) Infant/Toddler (0-3)Preschool (3-5)KindergartenSchool-ageTeenage 19. Your age <1919-3031-5051 or older 20. You are a: parentgrandparentfoster parentpartnerguardianOther If Other: 21. Is your child eligible for Free or Reduced Lunch or Title XX (Child Care Subsidy)? yesno

Supporting Families, Enriching Lives. Together for Tomorrow: Building Stronger Families. secure, happy children.

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