ADOLESCENT Survey

1. How many times do you see your mentor each month?

2. How many hours do you spend with your mentor when you see them? This question requires a valid number format.

hours

3. How many total months have you had a mentor? (For example: 1 and half years would equal 18 months) This question requires a valid number format.

months

4. How many adults who are NOT your family members do you trust and share your feelings with? Do NOT count your mentor in this number. This question requires a valid number format.

adults

5. How old are you? This question requires a valid number format.

years old

6. How many days per week are you at home alone without any adults for more than an hour? This question requires a valid number format.

days

ADOLESCENT Survey

Part 1 INSTRUCTIONS