2016-2017 Self-Advocate and Family Member Survey

If you are an individual with a disability or family member, and have been involved in a Wisconsin Board for People with Disabilities (BPDD) activity during the last year,please take a moment to complete this brief survey. This survey provides BPDD important information about the impact we are having on the lives of people with disabilities and their family members.

If you have already completed the survey this year, please do not complete it again.

As a result of participating in a WI-BPDD project or activity during the past year...........

Question Title

* 1. I have:

Made more choices about my supports

Gotten more involved in my community

Increased my knowledge of resources to help me self-direct

Participated more in self-direction

Increased the number of people other than paid professionals, that support me

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* 2. I have increased my participation in:

Paid community employment

Looking for a paid community job

Efforts to increase community employment for people with disabilities

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* 3. I feel more confident that:

I can work in paid community employment

I know what resources I can use to help me get a job in the community

When I work in the community the business I work for is better

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* 4. I have increased my self-advocacy

Yes

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* 5. I am better able to say what I want

Yes

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* 6. I am now participating in advocacy activities

Yes

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* 7. I am now on cross disability coalitions, advisory boards, governing bodies and or serving in a leadership position

Yes

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* 8. Please tell us whether you are:

An individual with a disability

Family member of an individual with a disability

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* 9. Please tell us whether you are:

White

Black or African American

American Indian and Alaska Native

Hispanic/Latino

Asian

Native Hawaiian and other Pacific Islander

Two or more races

Race unknown

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* 10. During the past year which of the following BPDD projects/activities have you participated in?

Let's Get to Work

People First

SPARKS Grants

Partners in Policy Making

Employment First Partner Grants

Take Your Legislator to Work

Promise

Self-Determination Conference

Employment First Conference

Youth Leadership Forum

Advocacy Trainings

Disability Advocacy Day

Supported Decision Making

Building FULL Lives in the Community Grants

Family Led Project

Other (please specify)

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* 11. Were you satisfied with the BPDD project/activity that you participated in during the past year?

Yes

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* 12. Is your life better as a result of participating in a BPDD project/activity during the past year?

Yes

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* 13. Please share a story of how participating in WI-BPDD activities has made your life better.

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* 14. Please provide the following information (optional):

Name:

Address:

City/Town:

ZIP:

Email Address:

Phone Number: