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Questionnaires
Youth Questionnaire – Probation
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User Information
Thank you for taking the time and answering our questions about how you are doing and the care you are receiving. What is reported in this questionnaire may be included in the local board’s report to the legal parties to the case. Your input will provide your personal view and is important for us to hear.
Name of Youth
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First
Last
Email
Address
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City
State / Province / Region
Board #: If Known
Meeting Date: If Known
Tell us how you are doing
What activities are you involved in?
Are there activities that you would like to be involved in but are currently not able to do?
Placement
Do you feel safe where you are living?
Do you feel you have experienced any form of discrimination since you have been placed outside of your home? Discrimination, for purposes of this question, is when a person treats you differently, unfairly, or worse because of some aspect of your identity.
Is there anything you would like us to know about where you are living?
Is there someplace else you would rather be living?
Education
How is school going?
What would help you be more successful in school?
What life skills are you learning? (Cooking, money management, how to find/keep a job, driving, etc.)
What do you want to do after high school?
What are your goals and do you need any help reaching these goals?
Visitation
Do you get to see your parents/guardians enough?
Do you get to see your brothers/sisters enough?
What would improve your visits with your family?
Who would you like to see that you currently are not able to?
Services
Do you know what needs to happen in order for you to go home?
Yes
No
If yes, what needs to happen for you to go home?
Contacts from people on your court case
How often do you talk with your Probation Officer?
Does your Probation Officer explain to you what you need to do to complete probation?
Are you getting all the help you need to complete probation?
Yes
No
If no, what do you need to help complete probation?
Does your attorney tell you what is happening on your case?
Yes
No
I don’t have an attorney
Additional Information
Is there anything else you want the adults involved with your case to know that would make your situation better?
Although not required, if you would like to submit any additional related documents you may do so below:
Accepted file types: pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt, Max. file size: 64 MB.
By returning this document, you confirm that the information is true and accurate and that you understand this information may be shared with the legal parties to the case.