FCSS Fathering for the Future Survey

Worker Email(Required)

A confirmation message will be sent to this email address.

Survey Selection

Client Information

First Name(Required)

Last Name(Required)

Demographic Questions

What Neighbourhood do you live in?(Required)

First 3 Digits of your Postal Code?(Required)

Country of Birth(Required)

Year of Arrival(Required)

Highest Grade Completed in School:(Required)

Accessibility

Do you have any long-term (over 6 months):

Difficulties with hearing, seeing, walking, climbing, or doing any similar activities?(Required)

Yes, Sometimes	Yes, Often	No

Emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia, etc.)?(Required)

Yes, Sometimes	Yes, Often	No

Cognitive difficulties such as learning, remembering, or concentrating, or doing any similar activities?(Required)

Yes, Sometimes	Yes, Often	No

Household

Number of Adults in Household(Required)

(18 or older)

Number of Other People in Household(Required)

(Under 18)

Total of People in Household(Required)

Positive Parenting Parent/Adult

We would like to know about parenting. Please describe how often each of the following statements describe you. Please do not leave any questions blank. Please answer the questions honestly.

I share an affectionate, warm relationship with my child.(Required)

I notice and praise my child(ren)s good behaviour.(Required)

I invite my child(ren) to play a game with me or share an enjoyable activity.(Required)

I teach my child(ren) new skills.(Required)

I speak calmly with my child(ren) when I am upset with them.(Required)

I make sure my child(ren) follow(s) the rules I set all or most of the time.(Required)

I set a routine for my child(ren) to get ready in the morning.(Required)

FCSS Post-Survey – Satisfaction Questions

We would like to know about your experience with this FCSS funded program.

Overall, I am satisfied with this FCSS funded program/service.(Required)

Overall, I found this program easy to access (e.g., it was simple to find the programming, easy to register, the referral process was straight forward, etc.).(Required)