Functional Minds Caregiver Questionnaire

Date *

Name of adolescent: *

First

Last

From your point of view, what do you think your adolescent is currently struggling with the most? *

If your adolescent has difficulties in areas of their life, do they speak openly to you about it? *

Do you the caregiver experience any difficulties to your mental well being? *

What are your expectations from the support group for your adolescent? *