Screening for Adverse Childhood Experiences
Our relationships and experiences—even those in childhood—can affect our health and well-being. Difficult
childhood experiences are very common. Please tell us whether you or your child have had any of the experiences listed
below, as they may be affecting your health today or may affect your health in the future. This information will
help you and your provider better understand how to work together to support your health and well-being. The information shared is anonymous and cannot be associated with your name/email. It will be utilized to assist Trauma Champions of Montcalm County in prevention efforts.