How Can We Help? We Want To Know What You Think Question Title * 1. What type of assistance are you looking for in the Autism/Special Needs Community? Access to occupational therapy Access to speech therapy Access to music therapy Access to art therapy Access to alternative medicine such as a holistic medical practitioner or herbalist/naturopathic doctor Access to a relevant psychologist, clinical psychologist or mental health specialist for myself, my household and/or special needs family member More social functions for special needs persons More inclusive programs closer to my living area An advocacy group in my local community Help with obtaining SSI, Medicaid/Medicare for my disabled household member(s) under 18 y/o Legal advise on obtaining guardianship for my minor disabled household member(s) Other (please specify) Question Title * 2. If enrolled in school, are you satisfied with the quality of instruction your student(s) is receiving in school? Yes - Public School No - Public School Yes - Private School No - Private School Does not apply - Not School Age Does not apply - Aged out of school We Homeschool Question Title * 3. If not, why? What was your/their experience like? (Optional) Question Title * 4. If enrolled in school, is there an I.E.P. presently being implemented? Yes No We just started the process of acquiring one I don't know what an I.E.P is, but would like to find out more Question Title * 5. What type of changes do you want to see in the special needs community and/or school system? Question Title * 6. Is there a particular topic regarding Autism/ Special Needs you'd like to see discussed or changed? Question Title * 7. Are you familiar with what Assistive Technology is? Yes No Familiar - but would like to learn more Question Title * 8. What Assistive Technology are you using, digitally or otherwise, at home or school? Is it helpful? Are you looking for alternatives to what you're currently using? Question Title * 9. Do you reside in Virginia? Yes No Question Title * 10. Do you reside in Prince William County, VA? Yes No Question Title * 11. Are you located within the DC Metro Area? Yes No Question Title * 12. Can we add you to our mailing list and stay in touch? Optional Name City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Email Address Done
