Presentation is loading. Please wait.

Presentation is loading. Please wait.

“A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. c/o South Central.

Similar presentations


Presentation on theme: "“A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. c/o South Central."— Presentation transcript:

1 “A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. c/o South Central Behavioral Health Network Inc., 205 Whitney Avenue, New Haven, Ct United Teen Connection, Inc TEEN TO TEEN HELPLINE S U R V E Y AGE: 10__ 11__ 12__13__ 14__ 15 __ 16 __ 17 __ 18__ 19 __ 20 __ 22__ Other __ GRADE 6 TH __ 7 TH __ 8 TH __ 9 TH __ 10 TH __ 11 TH __ 12 __ COLLEGE: ___________ NAME OF SCHOOL _______________ NAME OF YOUTH GROUP _____________ BEST SUBJECT __________________ WORST SUBECT ____________________ 1.Did you ever hear about United Teen Connection – Primary Prevention Teen to Teen YES __ NO __ If YES where did you hear about the program? Friend __ Parent __ School __ Bus __ Radio __ Public Access TV __ Internet __ Teen Life conference __ Youth Health Fair __ Community Program ___OTHER____________________________________ 2.When you are facing a problem or need support, where do you go for support/help/understanding? Friend __ Parent/Guardian __ School teacher __ School Nurse __ Neighbor __ Church __ School Guidance Counselor __ Other ________________________________________________________ 3.Do you think that there is a need for a service such as Teens Helping Teens TEEN HELPLINE and Training? YES __ NO __ If no why is there not a need _____________________________________ 4. Would you consider calling “Teen to Teen Helpline ” if you needed someone to talk to? (confidentially, anonymously and with no caller ID or use of *69) YES __ NO __ PLEASE TURN PAGE OVER AND COMPLETE QUESTIONS (THANK YOU)

2 5.During what hours do you think it is important for the TEEN TO TEEN HELPLINE be open? 3:00pm-6:00pm __ 3:00pm-8:00pm __ 6:00pm-8:00pm __ 5:00pm-8:00pm __Other _______________ 6.What kinds of problems or concerns would make you or a friend reach out for information/help/support? Academics __ boyfriend/girlfriend relationships __ birth control __ health __ Loss of a friend/relative __ Physical abuse __ loneliness __ Legal issues __ job issues __ sexual abuse __ dating violence __ sexual identity __ depression __ Hurting yourself __ Hurting others__ Running Away __ family concerns __ Hurting others __ OTHER ____________________________________________________________ 7.Have you ever called ? YES __ NO __ IF YES was services excellent __ good__ average__ below average __ poor __ OTHER ____________________________________ 8.Would you tell a friend who needs someone to talk to about our teen helpline? YES __ NO __ Why?________________________________________________________________ 9.Would you like to receive school Community Service Volunteer Credit Hours for participating in Training/ Answering Phone? YES __ NO__ 10.Would you use out teen to teen services or tell a friend about us? YES__ NO__ 11.In what capacity would you use our services? As a TEEN Calling in YES__ NO __ As a TEEN in Training for helpline YES__ NO __ BOTH (Teen in Training and Caller) YES__ NO__ 12.Would you like more information? YES __ NO__ If YES how can we get in contact PLEASE PRINT Phone: ________________________ _______________________ School counselor ________________ Name: _________________________ Address _____________________ Other __________________________ 13.Do you think this PROGRAM is worth funding? YES__ NO__ WHY?______________________________________________________________ THANK YOU FOR ANSWERING THIS SURVEY Please call us if you need further information on services offered or SH 1Survey


Download ppt "“A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. c/o South Central."

Similar presentations


Ads by Google