SCORE Form - Family Capability Building

1

Understanding your situation and your experience of our programs is important to us.

By filling in this survey form you help us to find out if our clients are better off as a result of being involved with our service. It also gives us valuable information to help us make changes to improve our programs. The results are confidential. There are no wrong answers!

2

Date* This field is required.

3

Name* This field is required.

First Name

Last Name

4

Playgroup Name* This field is required.

5

Playgroup End Date* This field is required.

6

I feel confident that I can parent my child/ren effectively* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

7

I have the skills I need to help my child/ren grow and learn* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

8

I am able to access information and support around my child's development* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

9

I feel connected to my comunity* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

10

I get involved with local activities or groups* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

11

My family and I have ongoing physical safety* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

12

My family and I have ongoing emotional safety* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

13

The workers at The Northern Centre listened to me and understood my issues* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

14

I am satisfied with the service I have received from The Northern Centre* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

15

Since accessing services at The Northern Centre, I am better able to deal with the issues I sought help with* This field is required.Empowerment, choice and control to make own decisions (G)

5. Strongly Agree

4. Agree

3. Not Sure

2. Disagree

1. Strongly Disagree

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Any other comments (what was useful or beneficial, or what can be improved)?

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Thank you for taking the time to complete this survey. If you have any questions or concerns about the survey process, please contact the Programs Manager at The Northern Centre on 02 9334 0111 or connect@thenortherncentre.org.au.