Home Visit Parent Satisfaction Survey
To help us make our program the best it can be, please complete this short survey about your experience. Your responses will be kept private. Thank you!  
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I am the child's... Mother, Father, or Other (If other please Specify)
My parent educator allows me to lead discussions about the needs of my family.
Clear selection
My parent educator helps identify my family's strengths.
Clear selection
My parent educator partners with me to identify goals that address the needs of my family.
Clear selection
My parent educator attempts to involve everyone in the room during our visit.
Clear selection
I feel comfortable talking with my parent educator.
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My parent educator is genuinely interested in me and my child.
Clear selection
Activities in the visits strengthen my relationship with my child.
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My parent educator encourages me to read books to my child.
Clear selection
My parent educator and I partner to set goals for my child, myself, and my family.
Clear selection
My parent educator helps me find useful resources in my community.
Clear selection
My parent educator gives me handouts that help me continue learning about parenting and child development.
Clear selection
This program motivates me to try new parenting strategies.
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This program increases my understanding of my child's development.
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This program helps me build relationships with other families.
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I feel less stressed because of this program.
Clear selection
I am satisfied with this program.
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I would recommend this program to a friend.
Clear selection
What about this program has been most helpful to you and your family?
What could be improved about this program?
How many total personal visits have you had?
Additional comments
Your parent educator's name (Optional)
Your name (Optional)
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