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SEEK Parent Questionnaire A Safe Environment for Every Kid No. Dear Parent or Caregiver: Being a parent is not easy. We want to help families have a safe environment for kids. We are asking everyone.

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How to fill out the Seek Questionnaire online

Filling out the Seek Questionnaire is an important step in ensuring a safe environment for your child. This guide will help you navigate the process of completing the form online with clear instructions and supportive guidance.

Follow the steps to complete the Seek Questionnaire effectively.

  1. Click the ‘Get Form’ button to obtain the Seek Questionnaire and open it in your preferred document editor.
  2. Enter today’s date in the designated field at the top of the form. This should be the current date when you are filling out the questionnaire.
  3. Fill in your child's date of birth. This is essential to ensure the information is specific to the child being evaluated.
  4. Select your child's sex by checking the appropriate box for either male or female. This demographic information helps in the assessment process.
  5. Respond to the questions regarding various concerns by checking 'Yes' or 'No' in the provided sections. It is important to answer openly to allow for the best support.
  6. Answer any additional questions, including if you need assistance with specific concerns such as support services, contact numbers, or other resources.
  7. Once you have completed the questionnaire, review your answers to ensure all information is accurate and complete.
  8. You can now save your changes, download a copy of the completed form, print it out for your records, or share it with the necessary healthcare provider.

Start completing your Seek Questionnaire online today to ensure a safe environment for your child.

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It is available on our SEEK Materials webpage. CPT code 96160 can be used for reimbursement for using the SEEK Parent Questionnaire – R (PQ – R). This code covers the administration of a patient-focused health risk assessment.

The revised SEEK Parent Questionnaire-R (PQ-R) is a tool to screen for the targeted problems: parental depression, substance abuse, major stress, intimate partner violence, food insecurity, and harsh punishment. It is completed in advance and given to the professional at the start of a regular checkup.

+ The SEEK Parent Questionnaire-R (PQ-R) is a brief evidence-based questionnaire to screen for prevalent and targeted psychosocial problems such as parental depression and substance use. The earlier version was revised in 2017 based on new knowledge and experience of those implementing the model.​

The SEEK PQ is an evidence-based tool used to briefly and systematically screen parents for prevalent psychosocial problems that are risk factors for child maltreatment, and that generally jeopardize children's health, development and safety.

The Mood and Feelings Questionnaire (Short Version) – Parent Report (MFQ-Parent) is a 13-item measure assessing recent depressive symptomatology in children aged 6-17 years. The MFQ-Parent is parent-rated and asks the parent to report how their child has been feeling or acting in the past two weeks.

The SEEK PQ is an evidence-based tool used to briefly and systematically screen parents for prevalent psychosocial problems that are risk factors for child maltreatment, and that generally jeopardize children's health, development and safety.

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