Infant Development Program Feedback Survey

Thank you for taking a few minutes to complete our program survey.  Your feedback is essential to our quality improvement process.  We are asking that you include your contact information in this survey.  This allows us to make sure we are meeting your family’s service needs.  Please be assured that all of the information you provide is kept secure and confidential.  Thank you again, we do appreciate your time and input.

Kootenay Family Place Infant Development Program Family Feedback Survey

Please include your name and community. Your information is confidential and will only be used to help us improve our services.

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0 indicates No, 10 indicates Yes
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0 indicates No, 10 indicates Yes
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0 indicates No, 10 indicates Yes
0
0 indicates No, 10 indicates Yes
0
0 indicates a long wait, 10 indicates a short wait
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0 indicates No, 10 indicates Yes
0
0 indicates No, 10 indicates Yes
0
0 indicates No, 10 indicates Yes
0
0 indicates No, 10 indicates Yes
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0 indicates No, 10 indicates Yes
0
0 indicates No, 10 indicates Yes
The age range of my child/children is: *
My family type includes: *