Caregiver/Parent Feedback Questionnaire Questionnaire Question Title * 1. What does the word autism mean for you? Question Title * 2. How do you prefer to describe your child's / loved one's diagnosis? (please select one) Person with autism Autistic person Person with ASD Person with Autism Spectrum Disorder On the spectrum On the Autism Spectrum Neurodivergent Neurodiverse I Use multiple I don’t use any of the above listed It doesn’t matter to me I use something else (please specify) Question Title * 3. Please provide any additional information on why you made that choice Question Title * 4. When looking for support for your child / loved one, what are you looking for? (please select all that apply) Treatment Programs (for example: skill building programs, play programs, communication programs, etc.) Therapy Intervention Coaching Services Consultation Respite Something else (please describe) Question Title * 5. Who are you looking for to support your child / loved one? (please select all that apply) Teacher Therapist Instructor Facilitator Coach Worker Support worker Something else (please describe) Question Title * 6. Is there anything else you think is important that we have missed or that you’d like to share with us? Your thoughts and ideas matter to us! Question Title * 7. Can we reach out to you for more feedback? Yes No Next