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Pre-Series Survey

Welcome to the Family Lunch & Learn series! This short survey will help us understand who is attending and what you hope to gain before we get started. Your answers are confidential and voluntary.

About You

Age
Gender
Female
Male
Non-binary/gender-expansive
Prefer not to answer
Race/Ethnicity
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
County of Residence
Relationship to loved one
Parent
Grandparent
Spouse/Partner
Sibling
Child
Friend
Other

Your Experience

How confident do you feel supporting your loved one’s recovery?
Not at all confident
Slightly confident
Somewhat confident
Mostly confident
Very confident
How confident do you feel caring for your own wellbeing?
Not at all confident
Slightly confident
Somewhat confident
Mostly confident
Very confident
How much do you feel you currently know about substance use disorder and family recovery?
This is pretty new to me
I have some basic understanding
I feel somewhat familiar
I feel very familiar

Your Hopes for This Series

Join Our Mailing List

THE CHRIS ATWOOD FOUNDATION

info@thecaf.org

10301 Democracy Lane, Suite 150

Fairfax, VA, 22030

703.653.4221

For TTY: Dial 711, then 703.653.4221

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©2024 by The Chris Atwood Foundation.

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