Initial Needs Assessment Survey for xMinds Stakeholders
On behalf of Partnership for Extraordinary Minds (xMinds), Ms. Kim Pinckney-Lewis (PhD Student at Old Dominion University) is conducting a needs assessment project: the data-driven search for opportunities to maximize individual, team, or organizational performance by contributing to the effectiveness, efficiency, and/or ease of supporting organizational goals. The current needs assessment will focus on the following areas:
1) how participation in xMinds' services contribute to parent efficacy (ability to advocate and produce desired results for their children), and
2) what opportunities there are to increase parent efficacy.
Ms. Pinckney-Lewis will also be exploring your experiences and feedback as you participate in this needs assessment. If you have any questions about this research, please contact her at or 856-905-7498 (cell).

First, complete and sign the Informed Consent section where you will have the option to download the full details of the project. In the survey sections that follow, please either select or fill in the appropriate response(s) for each item. Answer honestly to provide xMinds with the most accurate data. Your participation is greatly appreciated!

Upon survey completion, you may be entered into a lottery for the chance to win one of five $25 gift cards. To be entered in this lottery, you will need to provide your email address in a space provided at the end of the survey.

Click the “Next” button to proceed to the Informed Consent section.
Never submit passwords through Google Forms.
This form was created inside of Old Dominion University. Report Abuse - Terms of Service - Additional Terms