Family Check-up Survey

Please fill out the five question quiz below and press the "submit" button at the end so Welcome Baby can get a feeling of how you’re doing.  If you have any questions, please contact our Welcome Baby coordinator at: 801-374-8108.


Name:    

Does your family visit you every month?  Yes:  No:

Did you receive your Welcome Baby gift from your home visitor?  Yes:  No:  

Do you feel that you’re learning new things through the Welcome Baby Program?  Yes:  No:

If yes, what are they?

What is your favorite part of this program?

How do you feel this program can be improved?

Any additional comments:


We want to thank you for taking your time to fill out this short survey! Your answers will not only inform us on how you’re doing, but will contribute to the enhancement of this program.