Self Advocate & Families Survey

Every five years the Florida Developmental Disabilities Council gathers information to help us understand the needs of the people we serve and help us develop our State Plan for the next five years. What you tell us is important and helps us create solutions, so that your needs are better met. By filling out this survey you will help us learn which issues are important to you so that we can include some solutions in our next State Plan.

All responses will remain anonymous. If you need assistance completing this survey, or need the survey in an alternative format, please call the Council toll-free at 1-800-580-7801.

Please respond to this survey by April 1, 2010.

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1. What county do you live in?

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2. Where do you live?

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3. How old are you?

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4. Are you a

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5. What is your disability?

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6. Who do you live with?

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7. Who supports you where you live?

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8. Are you:

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9. In the last two years, what services or supports have you received?

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10. What service do you need that you are not getting?

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11. How would you improve the services you are getting?

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12. How has having a disability or a family member with a disability impacted your family?

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13. Is there anything else you want to tell us?

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16. Which group do you identify with?

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