Report on Family Law Research in Nunavut
APPENDIX TWO: Survey Instrument, Household Survey
Questionnaire-Family Law Survey
Hello I am from Nunavut Department of Justice. We are doing a survey about families and family law in Nunavut.
We would like to ask you to complete this survey.
All your answers will be confidential. We will group the information you provide with information from lots of other people, and your name will not be associated with it. Also, if there is a question you do not want to answer, you are not required to answer it.
Your participation is essential if we are to get a good picture of families in Nunavut. Because we are a new government, we need statistics about our people that are relevant to our people in order to design services and laws that meet our families most important needs.
Consent to survey
We would also like to ask your permission to contact you at some time in the future-perhaps five years from now-to follow up on this information.
- Consent to follow-up
- No consent to follow up
- Name of person completing survey:
- Phone number:
- Address:
Thank you very much for participating.
SECTION-PROFILE OF RESPONDENT
We would like to start with some questions about yourself to help us place you demographically.
- How old are you? Age (yrs)
- Male
Female (interviewer please note) - Are you an Inuk?
- Yes
- No
- What is the highest level of formal education you have completed?
- Some elementary school
- Elementary School
- Some high school
- High School Diploma
- Some college
- College Diploma
- Some apprenticeship or trades training
- Trades Certification
- Some university
- University Degree
- Graduate University Study
- What is your main source of income?
- Full-time wage employment
- Part-time wage employment
- Income Support
- Traditional activities (hunting, trapping, crafts)
- Other family member provides family income (specify)
- What is your first language?
- What other languages do you speak?
- What is your place of birth?
SECTION-HOUSEHOLD MAKE-UP
We would like to ask some questions about the people living in your household today.
Can you give the first name of each person in your household?
- Person's first name
- Relationship to Respondent
How is that person related to you:
- Husband/wife
- Common law
- Son or daughter
- Is s/he your
- birth child
- adoptive child
- stepchild
- Is s/he your
- Child for whom you are a guardian
- Father or mother
- Is s/he your
- birth parent
- adoptive parent
- step parent
- Is s/he your
- Brother or sister
- step
- - half
- adopted
- Grandchild
- Grandparent
- Son-in-law or daughter-in-law
- Father-in-law or mother-in-law
- Sister-in-law or brother-in-law
- Nephew or niece
- Uncle or Aunt
- Cousin
- Same-sex partner
- Other relative
- Non-relative
SECTION-CHILDREN (FEMALE RESPONDENT)
(Please do not count foster-children for this section)
- Have you ever raised step-children? By step-children we mean children from a former union of a spouse, or common law spouse?
- Yes
- How many have you raised?
- No
- Yes
- Excluding any step-children, have you ever adopted children in a process involving the courts?
- Yes
- How many have you raised?
- No
- Yes
- Excluding any step-children, have you ever adopted children by a custom adoption?
- Yes
- How many have you raised?
- No
- Yes
- Have you been a guardian of any children?
- Yes
- How many have you raised?
- No
- How long did the guardianship last (answer for each child) (#mos, #yrs)
- Yes
- Have you ever birthed a child?
- Yes
- How many have you raised?
- No
- Yes, and gave the child up for adoption
- Yes
- Do you have any grandchildren?
- Yes
- How many?
- No
- Yes
- Starting with the oldest, what is the first name of each child you ever raised or birthed? Include those who may have died.
- First Name
- Age (yrs)
- Sex (M/F)
- First Name
- How joined (Birth/Adopted/Step/Guard)
- Age joined (yrs)
IF NO KIDS, PLEASE PASS TO THE SECTION ON MARRIAGE
REVIEW THE FOLLOWING QUESTIONS (part A, B, or C) FOR EACH CHILD
CHILD NAME:
1 Does (Child Name) live in your household all the time, part of the time, or not at all?
- All the time-Please answer part A, D and E
- Part of the time-Please answer part C, D and E
- Not at all-Please answer part B, D and E
- Deceased-Please answer part D and E only
PART A - IF (CHILD NAME) LIVES IN THE HOUSEHOLD ALL OF THE TIME:
- A1 Does(Child Name)'s birth or adopted father live in this household?
- Yes
- No
- No, birth father is deceased
- A2 Has (Child Name) always lived in your household?
- Yes
- No
- A3 Before joining your household, what was (Child Name's) situation?
- Living with one birth parent
- Living with both birth parents
- Had a guardian or guardians
- Was adopted by another family
- Has lived in my household since birth
- A4 Has (Child Name) left your household since joining it?
- Yes
- No
- A4a If yes, why?
- Was adopted
- Went to live with other parent after marriage breakdown
- Went to live with another person after marriage breakdown
- Who was that person
- Social Services intervened
- Went to live with friends, or alone
- Went to live with a partner or spouse
- Respondent asked child to leave household
- Has not left household since joining it sometime after birth
- Other Specify
- A5 How long was (Child Name) away from your household?
- months
- years
- A6 How many times was (Child Name) living away from your household?
If birth father lives in household, please resume questionnaire at Part D
-
IF BIRTH FATHER DOES NOT LIVE IN HOUSEHOLD:
A7 Does (Child Name) have contact with her/his birth or adoptive father by. (check all that apply)- Overnight Visits
- Daytime Visits
- Telephone or letter
- No contact at all (IF NONE, SKIP THE NEXT THREE QUESTIONS)
- A7a If there are visits, how much time did (Child Name) spend with the birth or adoptive father in the past 12 months?
- months or
- weeks or
- days
- No time
- A7b How much time did (Child Name) spend with the birth or adoptive father in the past month?
- days
- weeks
- hours
- No hours in the past month
- A7c During the past 12 months, how often did the birth or adoptive father have contact with (Child Name) by letter or telephone when Child Name was not living in her household?
- Daily
- At least once a week
- At least once a month
- Less often than once a month
- Not at all
- A8 Is the household of the birth or adoptive father within:
- 10 km (in this community)
- A nearby community that can be reached by ground travel (up to 10 hours)
- Another community in Nunavut or the NWT that can be reached by plane only
- In Canada or the United States, but outside Nunavut or the NWT
- Outside Canada or the United States
- A9 Do you receive financial support for (Child Name) from the birth or adoptive father?
- Yes
- No
- A10 Do you receive material support, other than financial support for (Child Name) from the birth or adoptive father?
- Yes
- No
- A11 Does support cause a problem between you and the child's birth or adoptive father?
- Yes
- No
- What kind of problems?
- A12 Are you satisfied with the amount of financial support you receive for (Child Name) from the birth or adoptive father?
- Yes
- No
- A13 If you receive support, how often do you receive support?
- Regularly-at least once a month
- Fairly regularly-several times a year
- When he's working or hunting successfully
- Occasionally
- A14 If you do not receive support, did you ever request support?
- Yes
- No
PART B-IF (CHILD NAME) DOES NOT LIVE IN THE HOUSEHOLD AT ALL:
- B1 Who does (Child Name) live with?
- Child's birth or adoptive father
- A relative of the child Specify:
- Other Specify:
- B2 What was the reason (Child Name) left your household?
- Was adopted
- Went to live with other parent after marriage breakdown
- Went to live with another person after marriage breakdown
- Who was that person:
- Social Services intervened
- Went to live with friends, or alone
- Went to live with a partner or spouse
- Respondent asked child to leave household
- Other Specify:
- B3 Do you have contact with (Child Name) by. (check all that apply)
- Overnight visits
- Daytime Visits
- Telephone or letter
- No contact at all-How old was (Child Name) when you last had contact: yrs
If no contact at all, please skip the next three questions.
- B3a How much time did (Child Name) spend in your household in the past 12 months?
- months or
- weeks or
- days
- No time
- B3b How much time did (Child Name) spend in your household in the past month?
- days
- overnight stays
- weeks
- hours
- No hours in the past month
- B3c During the past 12 months, how often did you have contact with (Child Name) by letter or telephone when Child Name was not living in your household?
- Daily
- At least once a week
- At least once a month
- Less often than once a month
- Not at all
- B4 Relative to your own household, does (Child Name) live within:
- 10 km (this community)
- A nearby community that can be reached by ground travel (up to 10 hours)
- Another community in Nunavut or the NWT that can be reached by plane only
- In Canada or the United States, but outside Nunavut or the NWT
- Outside Canada or the United States
- B5 Are you satisfied or dissatisfied with the amount of contact you have with (Child Name)?
- Satisfied
- Dissatisfied
- No opinion
- B6 Why are you satisfied or dissatisfied?
- B7 Have you ever tried to change the child's living arrangements, or the amount of contact you have with (Child Name)?
- Yes
- No
- B8 What means did you use to change the amount of contact?
- Went to court
- Made an agreement directly with the person caring for the child
- Made an agreement using a go-between
- Who:
- Made an agreement with the child
- Other Specify:
- B9 Do you contribute financial support for (Child Name)?
- Yes
- No
- B10 Do you contribute other kinds of material support for (Child Name)?
- Yes
- No
IF YES
- B10a How often do you contribute support?
- Regularly-at least once a month
- Fairly regularly-several times a year
- When working or sewing regularly
- Other Specify:
- B10b Why do you contribute support for (Child Name)?
- Responsibility to kids
- Court Order
- Agreement
- Other (specify)
IF NO
- B10c Why do you not contribute support for (Child Name)?
- Was not asked to pay support
- No court order
- Agreement
- Paying for kids in my new family
- Have no obligation to pay-Why not?
- Other (specify)
PART C IF (CHILD NAME) LIVES IN HOUSEHOLD PART OF THE TIME
- C1 Who else does the child live with?
- Child's birth or adoptive father
- A relative of the child Specify:
- Other Specify:
- C2 Why does (Child Name) live in the household only part of the time?
- Joint/shared custody
- School-related reasons
- Other reasons Specify:
- Job-related reasons
- C2a If this is joint custody, do you and the other parent share:
- Residential custody of (Child Name)
- Making major decisions about (Child Name)
- Information about (Child Name)
- C3 How much time did (Child Name) spend in your household in the past 12 months?
- months or
- weeks or
- days
- No time
- C4 How much time did (Child Name) spend in your household in the past month?
- days
- overnight stays
- weeks
- hours
- No hours in the past month
- C5 During the past 12 months, how often did you have contact with (Child Name) by letter or telephone when (Child Name) was not living in your household?
- Daily
- At least once a week
- At least once a month
- Less often than once a month
- Not at all
- C6 Is (Child Name)'s other household within:
- 10 km (this community)
- A nearby community that can be reached by ground travel (up to 10 hours)
- Another community in Nunavut or the NWT that can be reached by plane only
- In Canada or the United States, but outside Nunavut or the NWT
- Outside Canada or the United States
- C7 Do you contribute or receive financial support for (Child Name)?
- Yes, I provide financial support
- Yes, I receive financial support
- No, I neither provide nor receive financial support
- C8 Do you contribute or receive other kinds of material support for (Child Name)?
- Yes, I provide material support
- Yes, I receive material support
- No, I neither provide nor receive financial support
- C9 Does financial or material support cause problems between you and (Child Name's) father?
- Yes
- No
- C10 If you do not receive support, does this cause a problem for (Child Name)?
- Yes
Why? - No
Why not?
IF SUPPORT IS PAID
- C11 How often do you contribute support?
- Regularly-at least once a month
- Fairly regularly-several times a year
- When working or sewing regularly
- Every once and a while
- C12 Why do you contribute support for (Child Name)?
- Responsibility to kids
- Court Order
- Agreement
- Asked to pay support by the person caring for the child
- Other (specify)
IF NO SUPPORT PAID
- C13 Why do you not provide support for (Child Name)?
- Was not asked to pay support
- No court order
- Have the kids a lot
- Paying for kids in new family
- Have no obligation to pay-Why not?
- Other (specify):
- C14 Are you satisfied or dissatisfied with the child's living arrangements?
- Satisfied
- Dissatisfied
- No opinion
- C14a Why are you satisfied or dissatisfied?
- C15 Are you satisfied or dissatisfied with the amount of contact you have with (Child Name)?
- Satisfied
- Dissatisfied
- No opinion
- C15a Why are you satisfied or dissatisfied?
- C15b Have you ever tried to change the child's living arrangements, or the amount of contact you have with (Child Name)?
- Yes
- No
- C15c What means did you use to change the living arrangements or the amount of contact?
- Went to court
- Agreement with the person caring for the child
- Agreement with the child
- Used another person as a go-between
- Who?
- Other
- Yes
PART D: WHERE (CHILD NAME) IS NOT LIVING WITH BOTH PARENTS.
(If one parent has died, or children are living with both parents, please move to E)
- D1 Did you ever enter an agreement with another person about the custody or support of (Child Name)?
- Yes, but we never wrote it down
- Yes, we have a written agreement
- No, we had no agreement
- No, the court made an order
- D2 Did you get outside advice about custody of your children, or financial support?
- Yes
- No
- D3 If yes, from whom:
- Parent
- Elder
- Friends
- Social Worker
- Courtworker
- Lawyer
- Other (specify):
-
If there was an agreement or a court order about custody
D4 Would you say that, overall, the time you spend with your children is;- Close to what was agreed/the court ordered?
- Less time than what was agreed/the court ordered?
- More time than what was agreed/ the court ordered?
PART E: FOR ALL PARENTS (ANSWER ONLY ONCE FOR ALL CHILDREN)
- E1 Overall, how satisfied are you with the amount of time you spend with your children?
- Very satisfied
- Somewhat satisfied
- Not very satisfied
- Not satisfied at all
- E1a Why
- E2 I think I'm a better mother than my mother/mother substitute was?
- Strongly agree
- Agree
- Disagree
- Strongly disagree
- No opinion
- Date modified: