Questionnaire

For the empirical research on

Analysis of Children with intellectual disability rights under The Rights of
persons with Disabilities Act, 2016, Mental Healthcare Act, 2017 and
National Trust Act, 1999

(Following data will be used for only academic purpose only and will not be shared to any
individual or group.)
1. Name:
2. Age:
3. Sex:
4. Occupation:
5. How many children do you have?
(a) 1 (b) 2 (c) 3 (d) more than 3
6. At what time you got to know about the condition of your child?
(a) At the time of birth (b) 0-3 years old (c) 3-8 years old (d) more than 8
years old
7. Whom you consulted first when you got to know about the mental condition of your
child?
(a) Doctor (b) Family/ Friends (c) Local tantrik
8. From where you got to know about this mental health establishment?
(a) Advertisement (b) Government Portal (c) Doctor (d) Family/ Friends
9. Does your child stays in this mental health establishment?
(a) Yes (b) No
9.1. If yes, For how much time?
(a) Last 15 days (b) 1-2 months (c) 2-6 months(d) more than 6 months
9.2. If no, how many times a month do you visit this mental health establishment?
(a) Once (b) Twice (c) Weekly (d) Regularly
10. How far is your residence from this mental health establishment?
(a) 0-5 kms (b) 5-20 kms (c) 20-40 kms (d) more than 40 kms
11. What is the level of facilities that are being provided in this mental health
establishment?
(a) Very Good (b) Good (c) Average (d) Below Average (e) Poor
12. Do you know about the facilities that are provided by the Government for the mentally
retarded children?
(a) Yes (b) No
12.1. If yes, from where you got to know about them?
(a) Doctor (b) Family/ Friends (c) NGOs (d) Government advertisement
and portals
12.2. If yes, are those facilities being beneficiary to you?
(a) Yes (b) No
13. Do you know about the rights of your child?
(a) Yes (b) No
13.1. If yes, how much?
(a) All (b) Almost all (c) Not much (d) A few
14. Do you know about the free legal aid that is being provided?
(a) Yes (b) No
14.1. If yes, have you ever availed it?
(a) Many times (b) Rarely (c) Never
15. Do you have BPL Card?
(a) Yes (b) No
15.1. If yes, do you know are entitled to get free medical aid using that?
(a) Yes (b) No
15.2. If yes, have you ever used that to get free medical aid?
(a) Yes (b) No
16. Does your child goes to school?
(a) Yes (b) No
17. Do you have any future education plans for your child?
(a) Yes (b) No
17.1. If yes, would you be considering any external aid for that?
 (a) Yes (b) No
17.2. If yes, from where you are thinking to get the aid?
(a) Government (b) NGOs (c) Family/ Friends
18. Do you know about any kind of financial aid that is being provided by the government?
(a) Yes (b) No
18.1. If yes, do you get any kind of financial aid/ remuneration from the
government?
(a) Yes (b) No

Suggestions, if any:
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Complaints, if any:
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