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“A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. 514 Foxon Blvd., PB 465 New Haven, Ct 06513 United Teen Connection, Inc. 203-789-8336 TEEN TO TEEN HELPLINE S U R V E Y

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“A simple program of educating teens to help themselves and others before a crisis develops” Mailing address: United Teen Connection, Inc. 514 Foxon Blvd., PB 465 New Haven, Ct 06513

  • United Teen Connection, Inc. 203-789-8336
  • TEEN TO TEEN HELPLINE S U R V E Y
  • AGE:10__ 11__ 12__13__ 14__ 15 __ 16 __ 17 __ 18__ 19 __ 20 __ 22__ Other __
  • GRADE 6TH __ 7TH __ 8TH __ 9TH __ 10TH __ 11TH __ 12 __ COLLEGE: ___________
  • NAME OF SCHOOL _______________ NAME OF YOUTH GROUP _____________
  • BEST SUBJECT __________________ WORST SUBECT ____________________
  • Did you ever hear about United Teen Connection – Primary Prevention Teen to Teen YES __ NO __ If YES where did you hear about the program?
  • Friend __ Parent __ School __ Bus __ Radio __ Public Access TV __ Internet __ Teen Life conference __ Youth Health Fair __
  • Community Program ___OTHER____________________________________
  • When you are facing a problem or need support, where do you go for support/help/understanding? Friend __ Parent/Guardian __ School teacher __ School Nurse __ Neighbor __ Church __ School Guidance Counselor __
  • Other ________________________________________________________
  • Do you think that there is a need for a service such as Teens Helping Teens TEEN HELPLINE and Training? YES __ NO __
  • If no why is there not a need _____________________________________
  • 4. Would you consider calling “Teen to Teen Helpline 203-789-8336” if you needed someone to talk to? (confidentially, anonymously and with no caller ID or use of *69)
    • YES __ NO __
  • PLEASE TURN PAGE OVER AND COMPLETE QUESTIONS (THANK YOU)
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During what hours do you think it is important for the TEEN TO TEEN HELPLINE 203-789-8336 be open?

  • __ 3:00pm-6:00pm __3:00pm-8:00pm __ 6:00pm-8:00pm _ 5:00pm-8:00pm
  • Other _______________
  • What kinds of problems or concerns would make you or a friend reach out for information/help/support?
  • academics __ boyfriend/girlfriend relationships __ birth control __ health __ loss of a friend/relative __ physical abuse __ loneliness __ legal issues __ job issues __
  • sexual abuse __ dating violence __ sexual identity __ depression __
  • hurting self __ hurting others__ running away __ family concerns __
  • OTHER ____________________________________________________________
  • 7. Have you ever called 203-789-8336? YES __ NO __ IF YES was services excellent __ good__ average__
  • below average __ poor __ OTHER ____________________________________
  • Would you tell a friend who needs someone to talk to about our 203-789-8336 teen helpline? YES __ NO __
  • Why?________________________________________________________________
  • Would you like to receive school Community Service Volunteer Credit Hours for participating in Training/ Answering Phone? YES __ NO__
  • Would you use out teen to teen services or tell a friend about us? YES__ NO__
  • 11. In what capacity would you use our services?
  • As a TEEN Calling in YES__ NO __
  • As a TEEN in Training for helpline YES__ NO __
  • BOTH (Teen in Training and Caller) YES__ NO__
  • Would you like more information? YES __ NO__ If YES how can we get in contact PLEASE PRINT
  • Phone: ________________________ email _______________________ School counselor ________________
  • Name: _________________________ Address _____________________
  • Other __________________________
  • Do you think this PROGRAM is worth funding? YES__ NO__ WHY?______________________________________________________________
  • THANK YOU FOR ANSWERING THIS SURVEY
  • Please call us if you need further information on services offered 203-789-8336
  • http://groups.yahoo.com/group/unitedteenconnectionnhct or united.teen.connection.n.h.ct@juno.com or henningersh@aol.com
  • SH: 1 Survey 6-16-2009