Military Strengthening Families Program Pre/Post-Test

Military Strengthening Families Program Pre/Post-Test

Funded by New Jersey Division of Mental Health and Addiction Services (DMHAS)
The following questionnaire is being conducted throughout New Jersey as a means to measure the effectiveness of the Military Strengthening Families Program. All response will be kept confidential and secure using HIPPA compliant security and encryption.

Your honest feedback and assistance is greatly valued and crucial to us. We thank you for your participation in the program.
Name:*

First NameLast Name
Email:*

Confirmation Emailexample@example.com
Program Instructor:*
Program Setting/Location:*
Please Select Program Test:*

	Always true or almost always true	True a lot of time	Hardly true or sometimes true	Not true
I am available when others in the family want to talk to me.
I listen to what other family members have to say, even when I disagree.
Family members ask each other for help.
Family members like to spend free time with each other.
Family members feel very close to each other.
We can easily think of things to do together as a family.

	Always	Almost Always	Fairly Often	About Half the Time	Not Too Often	Almost Never	Never
Get angry at him or her
Let this child know you really care about him/her
Shout or yell at this child because you were mad at him/her
Act loving and affectionate toward him/her
Let this child know that you appreciate him/her, his/her ideas or things he/she does
Yell, insult, or swear at him/her when you disagree
When this child does something wrong, how often do you lose your temper and yell at him/her

	Never	Once or Twice	Sometimes	Regularly	Very Often
Check your child's homework after it was complete?
Help your child do his/her homework?
Help your child prepare for tests?
Talk to your child about his/her experience at school with classes or classwork that day?
Talk with your child about his/her experience at school with friends or other school children that day?
Talk to your child about his/her experience with other school activities (sports, lunch time, etc.) that day?