Children's Cerebral Palsy Movement Spring 2019 Survey
Spring 2019 Survey for families within the Cerebral Palsy community.
Sign in to Google to save your progress. Learn more
Email *
First and Last Name
How did you hear about CCPM?  
What CCPM events have you attended? (check all that apply)
Which CCPM event has been your favorite and why?
How likely are you to attend another CCPM event?
Clear selection
Would a CP Summer Family Picnic be of interest to your family? If so, let us know when would be best.
Mid-Late June
July
Early-Mid August
Saturday
Sunday
How likely are you to attend our monthly Caregiver Workshop?
Clear selection
What day and time would be best for attending our monthly Caregiver Workshop? (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning
Afternoon
Evening
What do you value most from our Caregiver Insight Workshops?
Clear selection
What type of topics would you be interested in discussing for our Caregiver Workshops in the future?
How can CCPM support your family's journey with Cerebral Palsy?
What type of events would your family like to see more of?
What information would you like to gain from our blogs?
What is your family's biggest need within living with Cerebral Palsy?
How do you stay updated with CCPM's latest news and events?
Do you have any interest in volunteering or joining our Parent Action Committee?
Very likely
Not at all likely
Clear selection
Do you know other CP families that you can connect us with?
How likely are you to invite other CP families to be involved with CCPM?
Very likely
Not at all likely
Clear selection
Do you have any personal or business connections that could help us support our events, via in-kind or cash donations?
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of KWSM: a digital marketing agency. Report Abuse
Google Forms