Responses cannot be edited
Youth Navigator Program Survey
Please answer the following questions to the best of your ability so that we can direct you to the correct services.
Email address
Are you a person living with a disability between the ages of 15-25?
If you answered no above, please describe your relationship to a youth with disability
Are you or the youth applicable approaching 19 years of age?
What is the area of greatest concern?
Please describe the supports that you are currently receiving to help with your transition into adulthood
Please describe supports that you need but are not yet receiving
What supports would you find the most helpful in planning the transition to adult services?
How would you prefer to communicate with the Youth Navigator?
What is your child's disability?
How does their disability affect their life and their ability to strive?
On a scale from 1-10, 1 being the poor, 10 being the exceptional, how is your child’s overall physical health?
Poor
Exceptional
On a scale from 1-10, 1 being unsatisfied, 10 being extremely satisfied, rate how you feel your doctor and other health professionals such as physiotherapists and occupational therapists have been able to meet your child’s needs.
Unsatisfied
Extremely satisfied
On a scale from 1-10, 1 being the poor, 10 being the exceptional, how would you rate your child’s overall mental health?
Poor
Exceptional
Has your child been able to access adequate dental care?
On a scale from 1-10, 1 being the poor, 10 being the exceptional, how would you rate your child’s abilities with social interaction?
Poor
Exceptional
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Additional Terms