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Race
 
African American
 
White
 
Hispanic
 
Other
 
 
 
Gender
 
Male
 
Female
 
 
 
Age of Grandparent
 
Under 55
 
Above 55
 
 
 
How long have you been using the KIPDA Grandparent program?
 
1-2 yrs.
 
3-4 yrs.
 
5 or more
 
 
 
How many grandchildren are in your care?
 
1-2
 
3-4
 
4 or more
 
 
 
How many of the grandchildren in your care are receiving services from the KIPDA Grandparent Raising Grandchildren program?
 
1-2
 
3-4
 
4 or more
 
 
 
County
 
Jefferson
 
Henry
 
Trimble
 
Oldham
 
Shelby
 
Spencer
 
Bullitt
 
 
 
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 other community resources and services
 
Grandparent trainings or conference
 
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 educational supplies
 
Financial assistance with legal services
 
Financial assistance with medical services
 
Financial assistance with dental services
 
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

 
 
 
Has the service(s) you recieve from the KIDPA Grandparents Raising Grandchildren Program from July 2012 to June 2013 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

 
 
 
Please provide any suggestions that would improve services, or make them ore useful or accessible to you.
   
 
 
 
What services would like the program to offer that are not currently being offered?
   
 
 
 
Comments/Suggestions:
   
 
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