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Post-Tour Survey

Thank you for visiting the safety demonstration home today. We hope you enjoyed your tour. 

Please complete this brief survey. Your feedback is very important to us. 


  1. During your Safety Demonstration House tour, did you discover any areas/issues in your own home that are potential safety risks to a child?
  2. Do you feel that Charlie's House provided you with or directed you to the resources you need to make your home safe?
  3. As a result of what you learned from Charlie's House, will you be taking action to help prevent an accident or injury in and around your home?
  4. What are the ages of the children that reside in your home? (select all that apply)
  5. What is your ethnic background?
  6. What is your gender?
  7. Please indicate your age range