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Name of Grandparent Caregiver
   
 
 
 
County
 
Jefferson
 
Henry
 
Trimble
 
Oldham
 
Shelby
 
Spencer
 
Bullitt
 
 
 
Age(s) of grandchild(ren) you are caring for
   
 
 
 
What service(s) did you recieve from KIPDA Grandparents Raising Grandchildren Program from July 2009 to June 2010? (Please check all that apply)
 
Information about available resources and services
 
Assistance to obtaining services
 
Counseling (professional/pastoral)
 
Caregiver education opportunity or training
 
Support group information/referral
 
Supplemental Service
 
Financial assistance in purchasing child clothing
 
Financial assistance with respite care (Child care services or other respite care)
 
Financial assistance with educational supplies
 
Financial assistance with legal services
 
Financial assistance with medical services
 
Financial assistance with dental services
 
Quarterly Newsletter
 
Other
 

 
 
 
Overall, are you satisfied with the service(s) you recieved from KIDPA Grandparents Raising Grandchildren Program (KFCP) from July 2009 to June 2010? (Please check the most appropriate response)
 
Very Satisfied
 
Satisfied
 
Somewhat Satisfied
 
Unsatisfied

 
 
 
Do you feel that you are better informed about services and local resources available to grandparent caregivers through information provided by the program?
 
Yes
 
No
 
About the same
 
Unsure

 
 
 
Are you satisfied with the assistance you recieved in locating available services and resources from the grandparent program?
 
Very Satisfied
 
Satisfied
 
Somewhat Satisfied
 
Unsatisfied

 
 
 
Has the service(s) you recieve from the KIDPA Grandparents Raising Grandchildren Program from July 2009 to June 2010 helped you feel less stress in caring for your child(ren)?
 
Yes
 
No
 
About the Same
 
Unsure

 
 
 
Have your needs as a grandparent caregiver been met through the information and/or services provided by the KIPDA Grandparents Raising Grandchildren Program? (Please check the most appropriate response)
 
Needs were met
 
Needs were somewhat met
 
Needs remain about the same
 
Needs were not met

 
 
 
Has the granparent program assisted you in making decisions or resolving problems that you are experiencing as a result of being a grandparent caregiver?
 
Yes
 
No
 
About the Same
 
Unsure

 
 
 
Please provide any suggestions that would improve services, or make them ore useful or accessible to you.
   
 
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