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Disability services survey
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1.
Are you, or do you have a family member who is, a disabled adult with an intellectual disability? (such as autism, down syndrom, etc.
Note: If the answer to this question is NO, you can stop filling out the questionnaire.
(Required.)
Yes
No
Other (please specify)
2.
What country does your disabled family member live in?
3.
What state or province does your disabled family member live in?
4.
What city does your disabled family member live in?
5.
What kind of disability does your disabled family member have?
6.
What kind of services do they receive?
7.
Does your disabled family member receive services from a government entity, private provider, or both?
Governement
Private
Both
None of the above
Other (please specify)
8.
How satisfied are you with the quality of services that your disabled family member receives?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
Other (please specify)
9.
How easy or difficult is it for you to access services?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Other (please specify)
10.
How long does someone need to wait to receive services after moving to your area?
Thank you for completing this survey.