Family Survey


Protective Factors Survey

Part I. Please select the option that describes how often the statements are true for you or your family. The numbers represent a scale from 1 to 7 where each of the numbers represents a different amount of time. The number 4 means that the statement is true about half the time.

Part II. Please select the option that best describes how much you agree or disagree with the statement.

Part III. This part of the survey asks about parenting and your relationship with your child. For this section, please focus on the child that you hope will benefit most from your participation in our services. Please enter the child's age or date of birth and then answer questions with this child in mind.

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Child 8

Part IV. Please tell us how often each of the following happens in your family.

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Child 8

This survey was developed by the FRIENDS National Resource Center for Community-Based Child Abuse Prevention in partnership with the University of Kansas Institute for Educational Research & Public Service through funding provided by the US Department of Health and Human Services.