Client Survey - Athens Area Diaper Bank

1
Does getting diapers help your household?
Yes, it helps us a lot.
It helps us a little bit.
No, it does not help us.
2
Receiving these pull-ups/diapers for my child(ren) allows me to (check all that apply):
take my child to daycare
go to work
look for work
go to school or job training
buy food
buy clothing
buy non-food items like toothpaste or soap
pay a bill
spend more money on transportation (car payment, gas, vehicle repairs, bus pass, ride cost)
save money for another essential item
make my child happier
help my child cry less
help my child sleep better
help my child have less diaper rash
reduce my stress
feel less frustrated
feel like a better parent / caregiver
Other
3
Does getting diapers at this agency help improve the health of your child?
YESNO
4
Does getting diapers at this agency help you improve your family’s general wellbeing?
YESNO
5
Does getting diapers help you feel like a more knowledgeable parent/caregiver?
YESNO
6
Does getting diapers help you feel more confident as a parent/caregiver?
YESNO
7
Child health impact- Receiving these pull-ups/diapers for my child(ren) allows me to (check all that apply):
make my child happier
help my child cry less
help my child sleep better
help my child have less diaper rash
8
Household economic impact - Receiving these pull-ups/diapers for my child(ren) allows me to (check all that apply):
buy food
buy clothing
buy non-food items like toothpaste or soap
pay a bill
save money for another essential item
Other
spend more money on transportation (car payment, gas, vehicle repairs, bus pass, ride cost)
9
Caregiver impact - Receiving these pull-ups/diapers for my child(ren) allows me to (check all that apply):
reduce my stress
feel less frustrated
feel like a better parent / caregiver
other
10
Workforce impact: Receiving these pull-ups/diapers for my child(ren) allows me to (check all that apply):
Take my child to daycare
Look for work
Go to work
Go to school or job training
11
Is an adult in your household working outside your home?
YESNO
12
Number of children in your household that wear diapers or pull-ups:
13
How often have you needed diapers for your child or children but did not have enough?
Never
A few times a year
Every month
Every week
Every day
14
When you did not have enough diapers, what happened? (Scroll to see all options.) Please check ALL that apply:
Child did not wear a diaper.
Used a towel or other cloth as a diaper.
Used a diaper that was the wrong size.
Used a plastic bag as a diaper.
Child wore a diaper longer than usual.
Cleaned and reused a diaper that was wet or soiled.
Asked a friend, neighbor, or family member for diapers or money to buy diapers.
An adult in my household had to miss work.
An adult in my household had to miss school.
Child could not go to daycare.
Child could not visit friends or family.
Child could not participate in a community or school event.
Child got a rash.
Child got sick.
Child was unhappy.
I never experienced this situation.
Other
15
How do you receive diapers from us?* This field is required.Check ALL that apply
Please Select
Acceptance Recovery Center
Advantage Behavioral Health Systems
Adventure Bags Inc
Athens Area Emergency Food Bank
Athens Area Homeless Shelter
Athens Community Council on Aging
Athens First United Methodist Church
Athens Free Clinic - Clarke Middle School
Athens Neighborhood Health Center
Athens-Oconee CASA
Athens Parent Wellbeing/Reblossom
Athens Regional Library System
Brightpaths - Home Visitor
Brightpaths - Resource Closet
Bulldog Basics
Campus Kitchen at UGA
Children's Medical Services
Chosen for Life Ministries
Clarke Early Head Start
Colbert Methodist Church
Danielsville Evangelical Church
Deliverance Temple
DFCS
Diaper Bank Community Event (Mobile Distribution)
Easterseals North Georgia Barrow County
Family Promise of Athens
Foothills Regional High School
Gordon's Chapel
Jubilee Partners
Medlink
Neighborhood Leaders
Oasis Catolico Santa Rafaela
Oglethorpe County School System and Community Christmas
Perinatal Health Partnership- Northeast Health District
Peace Place
Project Safe
Sparrow's Nest
Support for Immigrant Families in Crisis
W.O.W Community Outreach Center
Waggoners Grove Baptist Church
Walking With Moms In Need
WIC
OTHER
16
How many times in the last year have you gotten diapers from this agency?
Once
A few times
Every month
Every week
17
Does getting diapers at this agency help you feel connected to other community services?
YESNO
18
Does getting diapers at this agency help you feel like the community cares about your family?
YESNO
19
Where do you live?
Athens-Clarke County
Barrow County
Jackson County
Madison County
Oconee County
Oglethorpe County
Other
20
Is there anything you want the Athens Area Diaper Bank to know? Where else do you think should diapers be available?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: