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  5. Camp Mariposa Quality Assurance Survey- Family
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Exit Survey
 
 
Hello: You are invited to participate in our survey to evalulate the impact of Camp Mariposa. In this survey, the family of the camper will be asked to complete a survey that asks questions about the camper, your family, and addiction. It will take less than 5 minutes to complete the questionnaire. Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Veronica HIll at [Phone Number] or by email at the email address specified below. Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
 
How many sessions has your child attended Camp Mariposa?
   
 
 
 
There are many families that experience addiction privately, why did you choose to share your story by sending your child to Camp Mariposa?
   
 
 
 
Who is the family member experiencing the addiction? 
 
 
 
What is the addicted family member's drug of choice?
 
 
 
How long has drugs impacted your family?
   
 
 
When evaluating the impact Camp Mariposa has had on your child, how would you rate it? 
Horrible Impact Bad Impact Okay Impact Good Impact Huge Impact
Level of Impact
-
 
 
 
If Camp Mariposa was to end, how would you feel?
Extremely Sad
Sad
Neutral
Happy
Extremely Happy
 
 
 
Is there any thing else you would like for Camp Mariposa to know about your family?