Dufferin Wellington FASD Services Caregiver Survey
You are invited to participate in a web-based online survey conducted by Dufferin Wellington FASD Services. This survey aims to establish the needs of primary caregivers of persons with FASD who access Dufferin Wellington FASD Services and ascertain their satisfaction with available services. It should take approximately 15 minutes to complete the survey.

PARTICIPATION
Your participation in this survey is voluntary. You may refuse to take part in the research or exit the survey at any time without penalty. You are free to decline to answer any particular question you do not wish to answer for any reason.

BENEFITS
Although there will be no direct compensation for participating in this survey, your responses will help ascertain the types of needs, as well as the level of need, for primary caregivers of children/youth with FASDs in Dufferin/ Wellington which will help develop and strengthen services offered.

RISKS
There is a risk that you may find some of the questions to be sensitive in nature, however, as mentioned, your participation is voluntary and you can skip any of the questions you feel uncomfortable answering.

CONFIDENTIALITY
Although the information you provide will be interpreted by Dufferin Wellington FASD Services members, your responses will remain anonymous to any other persons.

CONTACT
If you have questions at any time about the survey or additional thoughts, you may contact Heather Teeter, Practicum Student at 519-803-4955, heatherteeter@gmail.com, or Tara Leskey, FASD Coordinator at 519-941-1530 ext. 237, tara.leskey@dcafs.on.ca.
ELECTRONIC CONSENT: Please select your choice below. Clicking on the “Agree” button indicates that: You have read the above information and voluntarily agree to participate and you are a primary caregiver of a child/youth with FASD and have participated in, or are interested in accessing Dufferin Wellington FASD Services. *
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