Sample Survey

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Hello: Thank you for taking the time to provide the research team your responses. It will take approximately 3-5 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 from you. Your survey responses will be stricly 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 Mary Short at (281) 283-3324, or you can email [email protected]. Thank you very much for your time. Please start with the survey now by clicking on the Continue button below. Subject # Parent # Date Did your child spend any part of last night in her/his own bed? Yes No What time did your child go to his/her own bed? Did your child sleep in her/his own bed throughout the whole night? Yes No Did your child spend any part of last night in your bed? Yes No What time did your child come into your bed? What time did your child leave your bed? Are you currently in the intervention phase? Yes No What level is your child on? Where did your child sleep? Additional Comments/Suggestions for improvement