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Community Needs Survey

The survey as a person taking it will see it. About 5 minutes.

What this survey is for

A short survey, about five minutes, that asks people with disabilities, their families and the people who support them which Independent Living services they need but are not getting, how hard help is to find, and where they live. It gives a Statewide Independent Living Council or a Center for Independent Living a county-level picture of unmet need for a State Plan for Independent Living.

Who should fill this out? People with disabilities, family members, caregivers, advocates, and disability service providers. If you are filling this out for someone else, please answer based on your experience with them.

All the questions are on this one page. Answer what you can and choose "Submit my answers" at the end.

  • It takes about 5 minutes.
  • You may skip any question except the first one and the county question.
  • Your answers are confidential. They are reported only as counts, never with your name.
  • Giving your contact details is optional, and they are kept apart from your answers.
  • You can stop at any time. What you have answered so far still counts.

About this survey

Who are you filling out this survey for?

Required.

  • I have a disability
  • as an agency or disability service provider

Services you need

Which services do you need but are not getting?

Check all that apply. A box appears under each one you check, in case you want to say more.

  • Help knowing and speaking up for my rights
  • Help getting ready for emergencies or disasters
  • Help getting SSI, SSDI, food assistance, or other benefits
  • Help meeting people and staying connected
  • Help finding or keeping a job
  • Help with education or job training
  • Help finding a safe, affordable, accessible place to live
  • Help getting around
  • I am getting the services I need
How hard is it to get the help you need?

  • I cannot get help at all
  • I get some help, but not enough
  • I get help sometimes
  • I usually get the help I need

Where you live

Required. If you are answering for someone else, choose their county.

Stay in touch (optional)

Your contact information

Optional. Only fill this in if you would like someone to follow up with you. Your contact details are stored separately from your answers.