Logistics Survey

Program Logistics Survey

Thank you for taking the time to fill out this survey! This form requests information on what works best for your family so we can better plan programs that fit within our families' needs and interests.
Carrie Tingley Hospital Patient Name*

First NameLast Name
Guardian Name*

First NameLast Name
Which days of the week work best for your child/family to attend programs? Select all that apply.*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What times of day are easiest for your child/family to attend programs?*

Mornings (8am-11am)Midday (11am-2pm)Afternoons (2pm-5pm)Evenings (5pm-8pm)
How long of a program would your child/family prefer? (outside of events like Camp Adventure, Day of the Tread, etc. that are longer times)*

30 minutes1 Hour1.5 Hours2 HoursOther
How often would your child/family prefer to participate in programs?*

Once a monthTwice a monthWeeklyDepends on the program
What types of programs is your child/family most interested in? Select all that apply.*

Sports/physical programsArts & craftsSocial/community eventsSTEM/STEAM activitiesOutdoor recreationMusic/sensory programsLife skills programsFood/cooking programsOther
How long has your child/family been attending programs with the Foundation? Please indicate years/months.*
For example, 5 years, or 5 months
Additional notes:
Should be Empty:

Program Logistics Survey