What's Important to You?
It Matters to Us!
IMPORTANT INFORMATION ABOUT THIS SURVEY

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Advocacy, Inc. wants to make sure our services match what people with disabilities say is important in their lives. To do that, we do a survey every few years. We ask people with disabilities, their families and friends, disability advocates and others to tell us about things that are most important to them. You can help by taking a few minutes to complete this survey. Please remember, there are no wrong answers. We want to know what is important to you in your daily life.

For help filling out the survey, call 1-888-665-6602 (free) To do the survey online, go to: www.advocacyinc.org/survey.
When you are done, please mail the survey to:
Advocacy, Inc.
7800 Shoal Creek, Blvd., #171-E
Austin TX 78757
DEADLINE: September 30, 2008

Section 1: Your Important Issues

  1. Please read Section 1 all the way through before marking your choices.
  2. Then, select ranks of the five (5) items that are most important to you in your daily life. Rank #1 being the most important to you, then 2 for the next important ... all the way to 5
  3. Please Note: You cannot rank more than 5 choices
  4. If you want to add any comments to the survey, write in the the comment box at the end of this page.

NOTE: If you are a parent, family member or caregiver doing this survey on behalf of a person with a disability, please select the things that you feel most closely reflect his or her views. If you are a professional or advocate, please select the things you believe most closely reflect the views of the people with disabilities you know.

Section 1: The five things that are most important to me in my daily life are:

  1. Being able to make or be involved in making decisions about my life
  2. Knowing how to get the help or support I need to live where I want
  3. Going to school to learn skills I can use in my life
  4. Having help and support to stay out of trouble in school
  5. Being treated fairly if I get in trouble in school
  6. Being in regular classes with kids without disabilities
  7. Having technology that can help me do my school work better
  8. Having a plan and being prepared for my life after high school
  9. Understanding my rights in special education
  10. Being able to rent or own an apartment or house I can afford to pay for
  11. Being able to rent or own an apartment or house that's barrier-free
  12. Having a job
  13. Earning a good salary
  14. Having technology to help me get a job or do my job better or more easily
  15. Knowing my rights as a worker with a disability
  16. Being able to vote
  17. Having transportation that meets my needs
  18. Being able to see a doctor or other health care specialist (including mental health specialists) when I need to
  19. Knowing what health insurance I'm eligible for and how to get it
  20. Knowing what to do if I don't agree with my health insurance provider
  21. Being safe where I live
  22. Knowing what to do if I feel threatened or unsafe or have been hurt
  23. Being able to communicate about my health, safety and legal needs (with doctors, lawyers, police, etc.)
  24. Knowing what to do if my civil or legal rights are violated
  25. Getting out of a nursing home, state school or other institution
  26. Knowing how to be prepared for a disaster or emergency
  27. Other
  28. Other
  29. Other
  30. Other

Section 2: About You

Your zip code:

Your age group:

0 - 16
17 - 22
23 - 45
46 - 64
65 and over

Your race:

Hispanic
White
African-American
American Indian/Eskimo/Aleut
Asian Pacific Islander
Other Click the option first for the write-ins

You are a:

Person with a disability
Parent of a child with a disability
Family member or caregiver
Disability advocate
General public
Disaster Survivor
Professional:
Health/human services
Medical
Education
Other

Comments (if any)