Former Foster Care Questionnaire

Name:
Age:
Gender
Female
Male
Other
Race
White
African American
Hispanic
American Indian/Alaskan Native
Asian/Pacific Islander
What age were you placed into the foster system and what was the reason behind needing the placement?
What type of foster care were you in (foster home, group home, kinship, etc.)?
How was your experience within foster care or within group homes? Any abuse or neglect?
Did you "age out" of the foster care system?
Yes
No
Would you say you were a well-behaved student in high school or did you have behavioral issues?
Extremely well-behaved
Somewhat well-behaved
Some behavioral issues
Extreme behavioral issues
Did you graduate High School or receive a GED?
High School graduate
GED
High School dropout
Have you ever been homeless after leaving foster care (living on the streets, a friend’s couch, a homeless shelter, in your car, etc.)? How many occasions?
Do you believe it was more difficult to find employment due to being a former foster child?
After leaving the system, did you partake in any illegal activities (stealing, drugs, etc.)? Explain.
Would you say you have PTSD from your foster care experience?
Yes
No
Do you feel like the foster care system is a “broken system”? Why or why not?
Overall feedback and thoughts about foster care:
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