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Caregiver Support Group Interest Form

The MIND Foundation Canada is launching a support group for caregivers of children aged 6-12 years old with Autism Spectrum Disorder (ASD).  Bilingual (English and French) sessions will be led by mental health professionals and child supervision will be available. We want to hear from you! Help us shape the program by answering a few questions below about your needs and interests. 

1. Interest Form 

2. Contact Information

Support Group Organization

What are your main challenges as a caregiver of a child with ASD? (select all that apply)
What topics would you like the support group to cover? (select all that apply)
What do you hope to gain from participating in this support group? (select all that apply)
Do you have any preferences for the structure of the group? (select all that apply)

Commitment to Attendance

The support group will run once a week for 12 weeks, with each session lasting approximately 1 hour. To get the most out of the experience—for yourself and for the group—we kindly ask that participants attend at least 80% of the sessions (a minimum of 10 out of 12).

Do you feel you’ll be able to commit to this level of participation?
Yes, I can commit to attending at least 10 out of 12 sessions
I’m not sure yet, but I’m interested
No, I likely won’t be able to commit to this schedule

Preferred Meeting Times

These 1-hour support group sessions will be held on a weekday evening (beginning in September). To help us choose the best time, please indicate your availability for each day and time slot.

Which evenings would you generally be available to attend? (select all that apply)

Support Group Language

Availability of Childcare

Would you be interested in having a professional such as a special care counsellor or special educator supervise your child with ASD in a separate room while you participate in the support group?
Yes, I would find this helpful and would be more likely to attend if this service is available
Yes, I would find this helpful, but it would not affect my decision to attend
No, I do not need this service, but I will still attend the support group
No, I do not need this service, and it would not impact my attendance
Other

Understanding Your Child’s Support Needs

These questions help us better understand your child's unique strengths and needs so we can tailor the support group accordingly.

Please describe your child's verbal communication level.
Full verbal communication
Partial verbal communication or use of limited speech
Non-verbal
Uses alternative communication methods (e.g., AAC, sign language, PECS)
What type of educational setting is your child currently in?
Mainstream classroom without support
Mainstream classroom with support
Special education classroom within a regular school
School with individualized support for children with autism
Homeschool
Other
Please describe (if any) additional support your child receives at school or daycare. (select all that apply)
How would you describe your child’s daily support needs?
Requires minimal support with daily activities
Requires moderate support (e.g., needs help with routines, social skills, communication)
Requires substantial support with most aspects of daily life
Unsure / it varies greatly day to day
Other

Other

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