What is your relationship to the child you mainly care for?
- Parent
- Step-parent
- Grandparent
- Foster parent/guardian
- Adult sibling (18+)
- Other caregiver
- Prefer not to say
Which of the following best describe the child’s health needs? Select up to 3.
- Chronic physical condition
- Developmental disability
- Behavioral/mental health
- Acute or short-term condition
- Rare disease
- Medically complex (multiple conditions)
- Not sure
- Prefer not to say
- Other
In a typical week, approximately how many hours do you provide care for this child?
Overall, how much strain have you felt as a caregiver in the past 30 days?
How often do you perform each of the following caregiving tasks for the child?
Which areas of your life have been affected by caregiving in the past 30 days? Select all that apply.
- Sleep
- Work or school
- Finances
- Social life
- Mental health
- Physical health
- Family relationships
Approximately how many different healthcare providers has the child seen in the past 6 months? Please enter a whole number.
Rank your biggest coordination challenges (drag to order).
How easy is it to find clear instructions and information about the child’s care?
Attention check: To confirm you are paying attention, please select “I am paying attention.”
- I am paying attention
- I am not paying attention
- Prefer not to say
How helpful have these supports been in the past 6 months?
Which support formats would be most useful to you? Select all that apply.
- In-person groups
- One-on-one counseling
- Phone hotline
- Text or chat support
- Mobile app tools
- Printed guides
- Video tutorials
- Live webinars
- Peer mentor match
Briefly describe the biggest support gap you’ve faced in the past 6 months.
Max 600 chars
What is your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Which region do you live in?
What is the highest level of education you have completed?
What is your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Homemaker/caregiver not employed
- Student
- Unemployed seeking work
- Retired
- Unable to work
- Prefer not to say
Is there anything else you’d like us to know about your caregiving experience?
Max 600 chars
Welcome! This survey is for adult caregivers of children receiving medical care. It takes about 8–10 minutes. Please answer based on your experience with one child you mainly care for.
AI Interview: 2 Follow-up Questions on Caregiver Support Needs
Thank you for your time and insights—your responses will help improve support for caregivers.