Parent Survey

  1. Are you interested in out of home respite for your child with PWS?
  2. Would you be interested in case management services that would help you arrange and work with the Developmental Disabilities Services Office, NYS Department of Health, NYS Education Department and other NYS agencies.
  3. Would you be interested in home assessments and help to insure food security?
  4. Would you be interested in Educational Advocacy for your child?
  5. Would you be interested in social skills training for your child?
  6. Would you be interested in In-home behavioral training?
  7. Would you be interested in trainings covering a number of PWS related topics?

Name of Parent/Guardian:

Street Address:

City, State and Zip Code:

Name of individual with PWS:

Age of individual with PWS:

Sex of individual with PWS:

Phone #:

E-mail address:

Ages of other children in family living at home:

Comments: