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CRISP Registration Jul24-Jun25

Dear CRISP active participant parents,
This is the registration form to continue to participate in CRISP (Culturally Responsive Integrated & Strength-Based Parenting) training on 3rd Wed 5pm-6:15pm each month on https://meet.goto.com/robziemak.  During CRISP, we provide Incredible Years (IY) parenting education and practical health and social service information for families.  CRISP is funded through Health Care Authority's Dedicated Cannabis Account Prevention and foundation grants, for parents of children 0-18 years old and pregnant individuals who are receiving public assistance and are clients of either MultiCultural Child & Family Hope Center (MCFHC) and Answers Counseling.  

Please fill out this registration to participate in CRISP from now until June 2025 and receive monthly reminder emails.  This registration includes Incredible Years pre-survey questions. Please do NOT forward this registration form to others.  After we have re-enrolled current active CRISP participants who are eligible, we will reach out to interested parents who become eligible by becoming a client of MCFHC or Answers, by participating in at least 4 Strengthening Families Program sessions in the summer or 4 Triple P classes in the fall.

After you are registered, during each month that you participate in the entire session (with your First & Last Name displayed) and fill out the online survey, you will receive $20 Amazon gift card from rob@answerscounseling.org.


Thank you!
Bryan Neal (bneal@mchc.org), Amalia Perez (aperez@mcfhc.org), Roxy Magno (rmagno@mcfhc.org), and Turner Cagle (tcagle@mcfhc.org)
Suzanne Pak (suzanne@answerscounseling.org) and Rob Ziemak (rob@answerscounseling.org)
4. I am... (check all answers that apply to you): *This question is required.
5. I am eligible for CRISP because:  (choose one answer) *This question is required.
I plan to become eligible for CRISP in the future by:  (choose one answer) *This question is required.
My family receives at least one of these benefits:  (confirming household income below 200% FPL; check all answers that apply to you) *This question is required.
6. Who Did You Hear About CRISP from? *This question is required.
This question requires a valid date format of MM/DD/YYYY.
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11. Gender (choose one): *This question is required.
12. Race/ Ethnicity (check all answers that apply to you): *This question is required.
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13. IY Pre Survey: Parents should identify positive consequences for following the rules as well as negative consequences for breaking the rules. *This question is required.
14. IY Pre Survey: Family meetings to make decisions and rules are a waste of time. *This question is required.
15. IY Pre Survey: It is important for family members to practice anger management skills even if it makes them uncomfortable at first. *This question is required.
16. IY Pre Survey: When you are angry with your child its best to tell him/her immediately. *This question is required.
17. IY Pre Survey: Yelling at your children when you are angry with them gets the best results. *This question is required.
18. IY Pre Survey: I have clear and specific rules about my child`s association with peers who use alcohol.  (Note: if you only have really young children, please feel free to answer this to the best of your ability and judgment). *This question is required.
19. IY Pre Survey: I have explained my rules concerning alcohol use to my child.  (Note: if you only have really young children, please feel free to answer this to the best of your ability and judgment). *This question is required.
20. IY Pre Survey: I often tell my child how I feel when he or she misbehaves. *This question is required.
21. IY Pre Survey: When my child tells me something important, I let him/her know that I am trying to understand what he/she is feeling. *This question is required.
22. IY Pre Survey: I let my child know I care about him/her while setting limits and consequences. *This question is required.
23. IY Pre Survey: I have discussed our family values with my child on several occasions. *This question is required.
24. IY Pre Survey: Does your child help with family fun activities? *This question is required.
25. IY Pre Survey: Does your child like to get involved in such family activities? *This question is required.
26. IY Pre Survey: Do you have time to listen to your child when he/she wants to talk to you? *This question is required.
27. IY Pre Survey: Do you and your child do things together at home? *This question is required.
28. IY Pre Survey: Does your child go out with other family members to movies, sports events, or other things? *This question is required.
29. IY Pre Survey: Do you have friendly chats with your child? *This question is required.
30. IY Pre Survey: Does your child help with chores, errands, and/or other work? *This question is required.
31. IY Pre Survey: Do you talk with your child about how he/she is doing in school? *This question is required.
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