HOPE Health & Wellness:Parent Needs Assessments SY 22-23

Health Needs Survey SY 23

Thank you completing the SY 22-23 Parent Survey.  This brief survey will ask for information and your opinions about the health needs of children who attend HOPE Elementary School and their families. Your answers will help us plan, so that our work is most suited to this community.  Your input will also help us learn the best ways to deliver health services at our clinic, located at the school.  This survey will take about 10 minutes to complete. 

If your child attends this school, you may complete the survey.  If you have any questions about the survey or would like information about the results, please feel free to contact Sheila Harmon at 312-996-4656.  A full report will be sent to the Principal and to the Local School Council.  Again thank you for taking this survey.

Please answer each question by checking the box next to your answer.  There are no right or wrong answers to any question.  This information is confidential: your name and your child's name will not be included in your answers. 
1.In your family, how often does your child see a doctor or nurse for a CHECK-UP?  (Check the one that applies)
2.If you answered "Not very often, or never", what are the reasons that your child does not see a doctor or nurse?  (Check all the answers that apply)
3.Usually, how many times a year do you take your child for a medical appointment, sick or well? (Please check only one answer)
4.When you take your child for a healthcare appointment, how far d you have to travel to get there?
5.If your child needs medical care on a WEEKDAY between the hours of 9a-5p, where you would go?  (Check the one you most frequently use)
6.Do you worry about any of the following things related to getting medical care for your child?  (Check all that apply)
7.In your opinion, what are some of the strengths, qualities or characteristics of your child or children?
8.Does your child have any of the following illnesses or conditions?  (Check all that apply)
9.Do you or your child have any of the following concerns/needs?
10.Would you be comfortable with you, or your child seeing a doctor or a nurse over the computer (over video like Facetime, Skype) where the doctor or nurse is in a different office from the clinic location?
11.Has your child seen a dentist in the past 12 months?
12.Has your child seen a specialist in the past 12 months?
13.Has your child or family received help from a social worker, psychologist, or other mental health professional in the past 12 months?
14.Does your child have an IEP or 504 plan on file at the school?
15.Is your child frequently absent from school for any of the following reasons
16.Have you ever tried to get tested for COVID-19?
17.If yes, were you able to find a convenient place to receive testing?
18.To your knowledge, do you have or have you had a positive test for COVID-19?
19.If "Yes", describe the level of care you received, or are receiving:
20.Do you personally know anyone in your family, group of friends, or community networks who became seriously ill, or died as a result of COVID-10?
21.Have you received a COVID-19 Vaccine?
22.Do you plan on getting the COVID-19 Vaccine?
23.Did you know that you, your family members, and friends who are eligible for the COVID vaccine, can get it at the health center free of charge?
24.In your own words, what do you think is the biggest problem children face in the community, where your child's school is located?  This may be a health problem or any other problem that concerns you.  A brief answer will be fine. 
25.Who does your child live with most of the time? (Check only one answer)
26.How many of your children are enrolled in this school?
27.What are the things that you like most about your life:
28.When you have a problem, do yo have other adults that you can go to for help? (check all that apply)
29.What language is primarily spoke in your home?
30.How does your child get to school?
31.When you to take your child for a healthcare appointment, about how long do you have to wait to be seen? (Check one)
32.What kind of insurance do you have for your child?  (Check all that apply)
33.What kind of insurance do you have for your child?  (Check all that apply)
34.What is your Zipcode?
35.Is there anything else, that you would like for us to know?
Current Progress,
0 of 35 answered