Name: Age: Case of Child: Relationship to child: Instructions: Please place a check ( ) on the parenthesis that corresponds to your

answer. 1. Do you have a child with cerebral palsy? ( ) Yes ( ) No If yes, please proceed to the next question. If No, please stop and give the questionnaire to the researcher. 2. How many months or years have you been taking care of your child? ( ) 6 months and longer ( ) below 6 months If 6 months and longer, please proceed to the next question. If NO, please return this to the researcher. 3. Are you the mother or father of the child? ( ) Yes ( ) No If yes, please proceed. If no, please return this to the researcher. 4. Do you live in Mandaue City? ( ) Yes ( ) No If yes, please turn to the next page and answer the questionnaires attached. If no, please stop answering and return this to the researcher.