Service Needs

Service Needs Survey

This survey is to help us identify unmet needs in our communities so we may help address those challenges.  Questions 1-9 are specific to the individual with an intellectual/developmental disability.  Questions 10 and 11 are specific to the caregiver.  
1.What county do you live in
2.Current living arrangement
3.Current challenges keeping you from living where you want/unmet housing needs in your community: (mark all that apply)
4.What do you currently do during the day (mark all that apply)
5.Current challenges keeping you from doing what you want/Unmet needs in your community (mark all that apply)
6.Do you currently use technology to meet needs, if so please describe the technology you use and what need it meets.
7.Current challenges keeping you from using technology/Unmet needs in your community (mark all that apply)
8.Areas of importance to you/Unmet needs in your community (Mark all that apply)
9.Please rank accessibility in the following areas:
Poor
Good
Excellent
Home
Community
Transportation
Public Buildings
10.This question is specific to the caregiver: Do you feel your family unit has sufficient support to meet the needs of the individual with an intellectual/developmental disability?
11.What needs do you as the caregiver have to ensure you can sufficiently support the individual with an intellectual/developmental disability?