paper administration

Per KY DBH, online surveys have been disabled.
Please use paper forms.

KY-Moms PRE-Survey (pdf download)

KY-Moms POST-Survey (pdf download)

KY-Moms PRE-Survey, Spanish (pdf download)

KY-Moms POST-Survey, Spanish (pdf download)

KY-Moms Support Person PRE-Survey (pdf download)

KY-Moms Support Person POST-Survey (pdf download)

KY-Moms Classroom Administration Form (pdf download)


 
 

If you have any questions regarding the KY-Moms Program, please contact Katie Stratton with the Kentucky Department
for Behavioral Health: Katie.Stratton@ky.gov.

Thanks so much for helping us implement the KY Moms program!