Exploration Survey: Family

How are your family dynamics?

Whether your family is traditional, single-parent, foster, or blended, determine how you and your children are positioned for long-term wellbeing and healthy functioning, individually and as a group. By rating each statement, you get a picture of your family’s social and emotional intelligence, caring, teamwork and determine the need for a parenting support process and model. Please include comments. The more information you provide, the better we can support you.

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  • Do You Need Parenting Support?

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Please indicate the structure and size of your family (single parent, two parents, number, gender and age of your children)
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Please include what social, spiritual, communication or other skills you have been teaching your family
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • If so, do you rotate leadership of the family meetings so the children also have a turn leading them? Specify details of how often, the success of them, etc.
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Please specify the adults and children in your family and whether or not each feels these four feelings. Also, indicate if you proactively create experiences to strengthen each of the four feelings listed
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • What Challenges Are You Experiencing?

  • Would You Like Help With The Following?