Form 1 2013 National Adoption Month Survey

Public reporting burden for this collection of information is estimated to be 3 minutes per response to complete this questionnaire. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The control number for this project is 0970-0401. The control number expires on X/XX/XXXX.

2013 National Adoption Month Survey

Please let us know how you are using this year’s National Adoption Month website and how we can better meet your needs.

1. Which of the following best describes your professional background or role?

(Check all that apply.)

• Adopted person

• Adoption professional

• Adoptive parent

• Prospective adoptive parent

• Child protective services

• Foster care professional

• Foster parent

• Foster youth (current or former)

• Health/mental health

• Kinship caregiver

• Legal/courts (e.g., GAL, CASA, attorney)

• Media

• Permanency professional

• Public Information Officer

• Prevention/family support

• T/TA Network Provider

• Tribal Member

• Tribal Professional

• Youth

• Other profession (Please describe.)______

2. Which of the following best describes your workplace? (Check one.)

• Children’s Bureau’s Training and Technical Assistance Network

• Community-based organization/faith-based organization

• Federal agency

• Local or county public agency/organization

• National organization (e.g., nonprofit, advocacy)

• State agency

• Tribal agency/organization

• Other (Please describe.)____________

3. Which of the following best describes your role in your workplace? (Check all that apply.)

• Frontline worker (e.g., caseworker, direct service worker)

• Supervisor/manager

• Director/administrator

• Other (Please describe.)____________

4. Briefly describe why you are visiting the National Adoption Month website.

__________________________________________________________________

5. How do you intend to use the resources offered on the National Adoption Month website? (Check all that apply.)

• Inform National Adoption Month activities

• My own professional development

• Personal use

• Program improvement

• Provide information to youth, families, etc.

• Raise awareness

• To advocate for a specific child, family and/or policy changes

• Train staff/colleagues

• Other (Please describe.)__________

6. How useful are the information and resources available on the National Adoption Month website?

• Very useful (Please explain.)__________________

• Useful (Please explain.)__________________

• Somewhat useful (Please explain.)__________________

• Not at all useful (Please explain.)__________________

7. Please describe additional information and resources that you would like to see offered on the National Adoption Month website.

__________________________________________________________________________

The following resources are available on the National Adoption Month website. For each item, please indicate whether or not you have already used it or plan to use it.
Please select which resources you have used or plan to use.	Describe how you have already used or plan to use this resource.	Provide any comments or suggestions you have about this resource.
Sample email messages Sample signature blocks Sample social media message Widgets Partnering for Permanency: Effective Communication Strategies to Promote Adoption from Foster Care (Brief for PIO) Partnering for Permanency: Promoting Adoption through Effective Communication Efforts Media Toolkit for Child Welfare Leaders Partnering for Permanency: Working with Your Public Information Officer National PSAs and Digital Stories State PSAs and Digital Stories Youth Videos Video: Children Waiting for Adoption

9. Do you have any additional comments or suggestions that would make future National Adoption Month websites more helpful (e.g., theme, specific topics, additional tools, different formats)?

__________________________________________________________________________

If you require any additional assistance, please contact Child Welfare Information Gateway staff by email at info@childwelfare.gov or by telephone at 800.394.3366.

Thank you for your comments and suggestions. Your input makes a difference!

2013 National Adoption Month Polling Question

Are you (or do you intend to) share resources from this site through social media?

• Yes

• No