Birth Parent SurveyThese answers will remain confidential. In exchange for your participation in this survey, you will receive a FREE e-book of The Prodigal Daughter upon its release. You will also have the choice to be in the acknowledgments. *Answer only the questions you are comfortable with.151. Acknowledgments – please provide your name or how you’d like to be acknowledged (initials, etc.). If you would prefer not to be included, enter N/A.* 1. Acknowledgments – please provide your name or how you’d like to be acknowledged (initials, etc.). If you would prefer not to be included, enter N/A.*Clear selection2. Email to provide the free E-book when it is available (Feb 2024)* 2. Email to provide the free E-book when it is available (Feb 2024)*Clear selection3. Would you be willing to be a sensitivity reader? A sensitivity reader is a person who reads and evaluates a manuscript with the goal of identifying potentially problematic or offensive content aspects of identity. The reader provides feedback to the author or publisher, highlighting areas where the work may be inaccurate, insensitive, or offensive to certain communities or individuals. The goal of using a sensitivity reader is to ensure that the work is respectful, accurate, and inclusive, and to help prevent unintentional harm or offense to readers. 3. Would you be willing to be a sensitivity reader? A sensitivity reader is a person who reads and evaluates a manuscript with the goal of identifying potentially problematic or offensive content aspects of identity. The reader provides feedback to the author or publisher, highlighting areas where the work may be inaccurate, insensitive, or offensive to certain communities or individuals. The goal of using a sensitivity reader is to ensure that the work is respectful, accurate, and inclusive, and to help prevent unintentional harm or offense to readers.YesNoClear selection4. What is your age? (Two numbers) 4. What is your age? (Two numbers)Clear selection5. What is your gender? 5. What is your gender?Clear selection6. What is your ethnicity? 6. What is your ethnicity?Clear selection7. What is your relationship to the child you placed for adoption? 7. What is your relationship to the child you placed for adoption?Clear selection8. What were the circumstances surrounding your decision to place your child for adoption? 8. What were the circumstances surrounding your decision to place your child for adoption?Clear selection9. Did you choose an open or closed adoption? 9. Did you choose an open or closed adoption?OpenClosedClear selection10. For law research – what year did the adoption take place? (4 digit YYYY) 10. For law research – what year did the adoption take place? (4 digit YYYY)Clear selection11. Have you had any contact with your child since the adoption? If so, can you provide context on that experience? 11. Have you had any contact with your child since the adoption? If so, can you provide context on that experience?Clear selection12. How have you coped with the decision to place your child for adoption? 12. How have you coped with the decision to place your child for adoption?Clear selection13. Do you feel like you were adequately supported throughout the adoption process? 13. Do you feel like you were adequately supported throughout the adoption process?Clear selection14. Do you think that adopted children should have access to information about their birth families? 14. Do you think that adopted children should have access to information about their birth families?Clear selection15. Any other information you believe would be valuable to know in shaping the characters of this fictional work? 15. Any other information you believe would be valuable to know in shaping the characters of this fictional work?Clear selection
1. Acknowledgments – please provide your name or how you’d like to be acknowledged (initials, etc.). If you would prefer not to be included, enter N/A.*
2. Email to provide the free E-book when it is available (Feb 2024)*
3. Would you be willing to be a sensitivity reader? A sensitivity reader is a person who reads and evaluates a manuscript with the goal of identifying potentially problematic or offensive content aspects of identity. The reader provides feedback to the author or publisher, highlighting areas where the work may be inaccurate, insensitive, or offensive to certain communities or individuals. The goal of using a sensitivity reader is to ensure that the work is respectful, accurate, and inclusive, and to help prevent unintentional harm or offense to readers.
4. What is your age? (Two numbers)
5. What is your gender?
6. What is your ethnicity?
7. What is your relationship to the child you placed for adoption?
8. What were the circumstances surrounding your decision to place your child for adoption?
9. Did you choose an open or closed adoption?
10. For law research – what year did the adoption take place? (4 digit YYYY)
11. Have you had any contact with your child since the adoption? If so, can you provide context on that experience?
12. How have you coped with the decision to place your child for adoption?
13. Do you feel like you were adequately supported throughout the adoption process?
14. Do you think that adopted children should have access to information about their birth families?
15. Any other information you believe would be valuable to know in shaping the characters of this fictional work?
