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
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