WeFam Father's Initiative Survey

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Name
First Name
Last Name
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1. Are You currently...* This field is required.
Single
Married
Divorced
Separated
Never Married
Widowed
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2. How old is/are your child(ren)?* This field is required.
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3. So, What is the biggest barrier you're facing as a father, right now?* This field is required.Describe what blocks your progress as a father
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4. How often do you spend time with your child(ren)?* This field is required.
Often (3 or more times per week)
Sometimes (Once per week)
Every now and then
Always
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5. What specific goal(s) would you like to achieve within the WeFam Father's Initiative program?* This field is required.
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6. Have you tried to meet your goal(s) before joining the WeFam Father's Initiative program?* This field is required.
YESNO
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7. What was the effort(s) made toward meeting your goal(s)? Did they work as you needed?* This field is required.Describe an effort that has not led to success. Type N/A if never attempted.
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8. What things, in your fatherhood journey, trigger you in a negative way?* This field is required.(Whether in daily life OR with the guardian of your child)
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9. Is there anything, in your fatherhood journey, that has a positive impact to you?* This field is required.Describe what makes you happy or feel good.
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10. Who do you admire/listen to the most in life?* This field is required.Your idea of a positive role model OR someone you see as relevant
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11. Have you considered coaching as a relationship builder, or creating a hobby with your child(ren)?* This field is required.We believe coaching is a healthy and direct way to learn to work with your child(ren) or your community
YESNO
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12. What type of coaching did you do, or what hobbies were created for your child(ren)/community?
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13. If you could deliver one lesson in life, what would it be?* This field is required.Your personal life lesson rule can be anything you believe wholeheartedly in.
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14. PERSONAL QUESTIONS before ending: Do you have reliable transportation?* This field is required.
YESNO
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15. We have experienced the powerful impact of showing fathers in effort to represent our youth gets very high praise and helps change the narrative of our communities. Would you consent to WeFam taking your photo/video for this program and for professional purposes?* This field is required.This allows the organization to change the narrative of our communities by showing involved fathers pushing towards healthy relationships with their children, families, and/or community.
YESNO
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16. Do you have a felony?* This field is required.
YESNO
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17. How important are your goal(s) to you?* This field is required.(Rate 1-10)
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Please rate this survey with 1 being the Worst, and 5 being the Best.
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