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Time Out For Parents Pre-course QuestionnaireTim Simmonds2020-04-09T09:25:10+00:00

Pre-course questionnaire

We’d like to ask you to take a few minutes to complete this form. By doing so you’ll really help us to make sure our services are reaching as wide an audience as possible. Your information will remain anonymous and will not be used to identify or contact you.

Are you:SingleMarriedCohabitingSeparatedDivorcedWidowed

What is your age group?Under 2020-2425-2930-3435-3940-4445-4950-5455-5960+

What is your ethnic origin?
White:BritishIrishOther white
Asian/Asian British:IndianPakistaniBangladeshiOther Asian
Mixed:White and Black CaribbeanWhite and Black AfricanWhite and AsianOther mixed
Black/Black British:CaribbeanAfricanOther Black
Other:ChineseAny other

How many children do you have?012345+

What are their ages?

Do any of them have disabilities and/or special needs?YesNo

What are your reasons for attending the course?

The questions below ask how you feel about being a parent at the moment. Please answer them as honestly as you can. Tick the boxes you feel most appropriate. (1 is 'Not confident' and 7 is 'Very confident')

How confident do you feel to meet the challenges of parenting a teenager?
01234567
How well do you feel you understand parenting styles?
01234567
How well do you feel able to meet your teenager’s emotional needs?
01234567
How well do you feel you listen to and communicate with your teenager?
01234567
How confident do you feel in your ability to handle conflict with your teenager?
01234567
How confident do you feel in your ability to set and keep boundaries?
01234567
How confident do you feel in your ability to discuss difficult topics with your teenager?
01234567

Your date of birth (We only request this information to match up your pre- and post-course questionnaires. When this questionnaire is processed, this information will not be stored and will be destroyed.)

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