Through the eyes of a child

Brief Survey

We appreciate you answering three questions on how you plan to use Through the Eyes of A Child – Grandparents Raising Grandchildren fact sheet series.

The purpose of our survey is to learn and share with others how grandparents and professionals are using the Through the Eyes of A Child-Grandparents Raising Grandchildren fact sheet series. Your completion of the survey is voluntary and confidential. Completion of the survey implies your consent to participate.⁽¹⁾ If you have any questions about the survey, please contact Dr. Mary Brintnall-Peterson at: mary.brintnall-peterson@ces.uwex.edu or call at: (608) 262-8083.

The Evaluation Survey

Are you:

	grandparent/relative raising childen
	professional
	both professional and grandparent or relative raising child
	other

You plan to: (check all that apply)

use fact sheets for personal use within family
share fact sheets with grandparent or relative caregiver
use as an agency resource (link to Web site, handout, etc.)
use with individuals and families in counseling settings
use in support group settings
use as an educational resource in training others
use in media campaigns
other – please describe:

What do you see as the value of the fact sheet series?

⁽¹⁾Copy of the Human Subjects Protection Approval Form is on file in the UWEX Provost and Vice Chancellor's Office, 432 N. Lake Street, Room 521, Madison, WI 53706

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