Online Forms

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5. Parent Education & Resources Needs Assessment
   At Family & Community Support Services (FCSS), we offer programming to support our community and to help local families.
   Please take a few minutes to complete this brief survey to let us know, as a parent, what supports and services would benefit you.
   This information will inform our future parent education/support services. For a listing of our current services, please visit our webpage: hinton.ca/123
7. Child's Age*
   -- Select One --0-56-89-1213-1516-18Over 18

   Please select the age of your child
8. Number of Children*
   -- Select One --12345+

   Please select the number of children you have.
10. What are your parenting concerns?
    Please list any struggles you have been experiencing as a parent.
12. What are your parenting successes?
    List some of your accomplishments as a parent that you're proud of.
14. What are some topics you would like to learn more about?*

    1. Sleep training for babies and toddlers
    2. Sleep for older children and teens
    3. Nutrition for babies and toddlers
    4. Nutrition for older children and teens
    5. Child development
    6. Technology use/screen time for children
    7. Keeping children safe online
    8. Keeping teens safe online
    9. Teens and drug use
    10. Puberty and changes in your child
    11. Socializing babies/toddlers
    12. Socializing older children/teens
    13. Improving family relationships
    14. Being a single parent
    15. Managing a family budget
    16. Effective discipline strategies
    17. Balancing work and family life
    18. Establishing routine and setting limits
    19. Sibling rivalry
    20. Parent stress, anxiety, & self care
    21. Other

    Please select all that you would be interested in
16. What else would you like to learn about or what other resources would be helpful to you as a parent?
    Please list any other courses, education opportunities, supports, or resources that you would like to see offered to parents in our community.
18. Can we follow up with you?*

    1. Yes
    2. No

    We will use this feedback to develop our future programming. We would like to keep you in the loop with emails or phone calls about our future programming. If you would like to be contacted, please provide your email address and phone number below.
20. Email Address
21. Phone Number
23. Please check beside any additional programs you would be interested in:

    1. Out-of-school care (for ages 5-12)
    2. Transportation services
    3. Friendly Visitor Program
    4. Family abuse prevention
    5. Volunteer Income Tax Program
25. Additional Comments
    (please add any additional feedback here)
27. Thank You!
    We appreciate your time in helping us offer the most useful programs and services to parents in our community.
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field