MARE Agency Survey

NOTE: This survey should be filled out by each parent individually.

Please fill in the following fields

* - Required Field

*Please select an Agency:

Family Race:

Marital Status:

Age:

Gender:

How many agencies have you had contact with?

What type of information were you seeking?
Adoption
Foster Care
Foster-to-adopt
Kinship
Guardianship
Step-Parent Adoption
Training Opportunities
Orientation
General Information
Other

Did this agency work with you in a prompt, courteous and professional manner?

Additional Comments: (optional)

Was the information you received thorough and complete?

Additional Comments: (optional)

Were you satisfied with the services the agency provided to you?

Additional Commens (optional)

Were there barriers to your ability to become a foster or adoptive parent?
Lack of response from the agency
Fees associated with agency services too expensive
Unable to get foster care license or Family Assessment complete in a timely manner (i.e., less than six months)
Other Barriers: (Please describe)
No Barriers
No Answer

Other Barriers:

Where are you in the adoption / foster care process?

Please tell us about the child or children you want to foster and/or adopt:
Infant Adoption
International Adoption
Special Needs Adoption
Foster Care
No Answer

Age:
Any Age
Younger than 6 years
6 - 10 years
11 - 13 years
14 or older
No Answer

Child Race:
Any Race
Black-African-American
White/Caucasian
Native American/American Indian
Hispanic/Latino/Latina
Asian American/Pacific Islander
Chaldean/Arab-American
Other
No Answer

Child Impairments:
Any Impairments
Having Emotional/Behavioral Issues
Having Physical Impairments
Having Developmental Delays
Having Learning Impairments
No Answer

Child Grouping

Additional Comments: (optional)