PHP website questionnaire Question Title * 1. Name and/or contact information (optional) Question Title * 2. How did you first learn about Parents Helping Parents? Question Title * 3. I am connecting with Parents Helping Parents for the following reasons (select one or more): For a loved one (adolescent or adult child) suspected of having a drug/alcohol problem To learn about prevention tools and resources for my child As a professional in a related field to learn more about Parents Helping Parents and support its mission To find out about how I can help (please contact me) Other (please specify) Question Title * 4. If you have not already done so, do you wish to be added to our (undisclosed) e-mail list where you will receive updates on meeting dates and topics for our chapters? Yes- I have provided my e-mail address below I am already receiving e-mails Not at this time Please provide your e-mail address. If you have a chapter preference (ex: Edmond, Norman, Oklahoma City, Wichita, etc.) please designate Question Title * 5. Have you yet attended any of our chapter meetings and/or called one of our chapter helplines? Yes: chapter meeting(s) Yes: chapter helpline No Which chapter? Question Title * 6. Do you find a parent support group such as Parents Helping Parents to be valuable? Yes No Unsure I have not yet made use of any of these resources Please elaborate: Question Title * 7. What services/programs offered by Parents Helping Parents do (or would) you find helpful? Education by guest speakers at meetings who are professionals in related fields Information and referrals to local/statewide/national resources to which I can connect for help Support from other parents who have walked in my shoes Reading materials including lending library books and DVDs Parent Peer Coach: Call 1-855-DRUGFREE to be connected to a parent peer coach via telephone (free resource) Parent roundtable meetings where parents can share and ask questions (non-speaker meetings) Other (please specify) Question Title * 8. Would you recommend Parents Helping Parents to others? Why or why not? Question Title * 9. Would you be willing to be added to a list of volunteers to be contacted as opportunities arise for help on committees and other special events/programs? If so, please provide your name, phone #. and e-mail here. Also add any preferences on how you would like to assist (special skills, interests, etc.) Question Title * 10. Please add any other comments, feedback, or information on how we can best meet your needs: Done
