Survey for Parents

Survey for Parents
Help us learn more about relationships across generations. Your thoughts count!
This survey gathers information to be used in a nonfiction book about relationships within extended families. The author will not identify respondents, but may quote or paraphrase your comments. If you agree, please tick "I agree."*

I agree.I do not agree.

1. First, please tell us about the children living in your household. Enter the number of children living in the household in the column that best describes the child's age. If you have children living in more than one household, please provide information for each household.

Rows	Under Age 4	4 - 7	8 - 11	12 - 15	16 - 18	Young adult
My Household
Another Household 1
Another Household 2

2. In general, my relationships with my children are:*

	1	2	3	4	5	6	7	8	9	10

1 is Rotten--not what I hoped for., 10 is Better than I ever dreamed!

3. Share comments or stories about your relationships with your children here:

4. Now tell us about the adults who live in your household. If you have children living in more than one household, provide the information about those other households. List them in the same order you used above. For each family, click the box that best describes the adults living in the household as they relate to the children.

Rows	Birth Father	Birth Mother	Stepfather	Stepmother	Adoptive parents	Other
My Household
Other Household 1
Other Household 2

5. Share comments or stories about your relationships with other adults in these households here:
6. How many grandparents do your children have?*

7. Next, tell us about your relationship to your children's grandparents. For each household of grandparents, click the boxes that best describes the adults living in the household as they relate to you.

Rows	Father	Mother	Father-in-Law	Mother-in-Law	Stepfather	Stepmother	Adoptive parent	Other
Grandparents 1
Grandparents 2
Grandparents 3
Grandparents 4
Grandparents 5
Grandparents 6

8. My relationships with my children's grandparents are:*

	1	2	3	4	5	6	7	8	9	10

1 is Rotten--not what I hoped for. , 10 is Better than I ever dreamed!

9. Share comments or stories about your relationships with your children's grandparents here:
10. Do your children spend enough time with their grandparents?*

Too much!YesNo, because they live far awayNo, because of schedulesNo, because of tension
11. Share comments or stories about your children's time with their grandparents here:
12. Do grandparents participate in the day-to-day care of your children?*

Yes, routinelyYes, occasionallyNo
13. Share comments or stories about grandparents caring for your children here:
In this next area, please rank the importance of each item, where 1 = "I don't care at all about this" and 5 = "This is very important to me."

14. I want my children to have close relationships with their grandparents.*

	1	2	3	4	5