1.Your Name (First Name Only)

2.Your email address

3.Are you the parent of a 12-16 year old daughter that has been diagnosed with autism?

Yes

No

4.Has your daughter with autism received a high-functioning diagnosis?

Yes

No

Unsure

5.Has your daughter with autism received a level 1 diagnosis?

Yes

No

Unsure

6.Has your daughter with autism received an Asperger's diagnosis?

Yes

No

Unsure

7.Does your daughter with autism have at least one older sibling who has not not been diagnosed with autism?

Yes

No

8.Do you share fulltime residence with your daughter and her older siblings?

Yes

No

9.Has your daughter's older sibling(s) without autism lived with her since birth?

Yes

No

10.Does your daughter's older sibling(s) without autism currently share a full time residence with her?

Yes

No