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What provinces does your organization work in?
 
Banteay Meanchey
 
Battambang
 
Kampong Cham
 
Kampong Chhnang
 
Kampong Speu
 
Kampong Thom
 
Kampot
 
Kandal
 
Koh Kong
 
Kracheh
 
Mondul Kiri
 
Phnom Penh
 
Preah Vihear
 
Prey Veng
 
Pursat
 
Ratanak Kiri
 
Siem Reap
 
Preah Sihanouk
 
Stung Treng
 
Svay Rieng
 
Takeo
 
Otdar Meanchey
 
Kep
 
Pailin
 
Tboung Khmum

 
 
 
What types of services does your institution provide?
 
Education;
 
Health;
 
Community Based Rehabilitation;
 
Physical;l Rehabilitation;
 
Clinical services;
 
Arts;
 
Other
 

 
 
 
Does your organization collect information about users Civil Registration documentation (Birth Registration, Id Card, Family book, Residential book or Passport)?
 
Yes
 
No
 
Don't know / Not sure
 
 
 
Is birth registration / birth certificate a pre-condition to access the services at your organization?
 
Yes
 
No
 
Don't know / Not sure
 
 
 
If a child has no birth registration / birth certificate documentation does the organization have a process / course of action to address this?
 
Yes
 
No
 
Don't Know / Not sure
 
 
 
How does the organization respond to the absence of civil registration documentation?
   
 
 
 
How many children are currently using your institution services?
   
 
 
 
How many girls with disabilities are using the institution services
   
 
 
 
How many children with disability have a birth certificate?
   
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
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