Parent Support Services Society of BC

    Parent Circle Feedback Survey

Dear Support Circle Member,

Thank you for taking the time to fill out this form.  Your opinions and comments are important to us and also to our funders.  Everything you share with us in this form helps us to improve the Support Circle Program. Your input also will be valuable for our future work of raising money to keep the programs going and in letting others know about the value of the Circles.


All information you provide us is confidential and your name will not be on the form. Your form will be read only by the Program Coordinators and Executive Director of PSS and will not be shared with anyone else. However, if a questionnaire is not submitted in English, either a facilitator or steering committee member will view written comments for translation purposes prior to submission. Your facilitators will not read your comments; however, they will get a summary report on the overall evaluation from your region.  This will help them in their future role as your facilitators.

Please take the time you need to think quietly about how you see yourself as a parent and how your Circle is working for you.  We are very interested to know how you have changed and what you have learned since you joined the Support Group. If you don’t want to answer any particular question, that is fine too.

Thank you,

Carol Ross MSW
Executive Director, Parent Support Services Society of BC

EMAIL
TODAY’S DATE:
Circle's Name: *
Your community:
Gender
    

Age







How long have you been in the Circle?




How may times do you attend your Circle each month:




If there is onsite child minding available with your Circle, do you use this service?
      

Please tell us everything that makes it hard or sometimes impossible to attend the Circle?








If chosen other at the previous questions, please tell us what makes it hard to attend the circle.
For the following questions, select the word that most closely describes the statement for you.
1. I look for new ideas and skills to use with my child(ren).
2. I learned new ideas and skills from the circle that I use with the child(ren) I am parenting.
3. I am able to set healthy limits with my child(ren).
4. I am a good parent.
5. I handle my frustration and stress well.
6. I feel comfortable talking to my child(ren)’s teachers/day care workers in order to support my child(ren).
7. I have fun with my child.
8. I am calm with my child.
9. I choose discipline related to my child(ren)s misbehavior
10. When my child misbehaves I think it is his/her fault.
11. When my child misbehaves I think it is my fault.
12. I feel confident about the discipline I use.
13. I have support as a parent.
14. I know and use community resources for me and my child.
15. The circle has provided the opportunity to be supported by others in a similar situation.
16. I am afraid I will be reported to MCFD.
17. I can advocate for myself and my child(ren) when needed.
18. I am comfortable in the circle and feel like I belong.
19. In the circle, I talk about my feelings and my parenting skills.
20. The circle has given me a place to vent the stresses and share the concerns I experience.
21. I am able to provide support to others in the circle.
Have you ever had contact with the Ministry of Children and Family Development (MCFD) due to concerns about the child(ren) or your parenting?
      

Do you need more support in your involvement with the Ministry?
    

If yes, in what ways would you need support?







If chosen other at the previous questions, please tell us in what ways would you need support
How has the circle helped you with your parenting?

How would you describe your Support Circle to a friend?

What would make your Support Circle work better for you?

Other comments?

Please select the category below that best describes your family’s total annual income








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