Survey on resources for people with disabilities

The Resource Center would like to learn how people with disabilities find information about services and supports that are available to them. People with disabilities can complete this survey themselves. Or they can have a family member, friend or support staff assist them to complete the survey. Family members, caregivers and support staff also may complete the survey themselves to provide their perspective.

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* 1. Who are you?

I am a person with a disability.

I am a Family member / Caregiver / Friend of a person with a disability.

I am a support staff for a person with a disability

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* 2. How do you find information you want?

I use the Internet.

I call the business or agency.

I ask a family member or friend.

I ask my support staff.

I ask my Care Coordinator/Service Coordinator

Other (please specify)

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* 3. Please list the web sites you use to find information for people with disabilities.

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* 4. Have you ever visited web sites such as www.inthedriversseat.org or www.211wny.org to find information for people with disabilities?

Yes

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* 5. If you have used www.inthedriversseat.org or www.211wny.org, please tell us what you like (and what you don't like) about those web sites.

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* 6. Is it hard to know where to look for information?

Yes

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* 7. What would help you find useful information?

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* 8. What services/supports do you want to know about MOST? Please select no more than 5 categories.

Day Programs and Activities

Self-Directed Services

Job Training and Employment Programs

Volunteer Opportunities

Housing/Shelter

Food and Nutrition

Transportation

Health Services

Advocacy and Support Groups

Financial Assistance

Legal Assistance

Using a computer or smart phone

Cultural activities

Hobbies

Sports and Recreation

Religious Services

Dating

Child Care

Programs for Seniors

Other (please specify)

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* 9. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 10. Please share any other information or questions you have.

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* 11. If you would like us to contact you, please tell us who you are and how to reach you.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 12. How should we contact you?

Phone