PWCL SURVEY Question Title * 1. Name: Question Title * 2. Town: Question Title * 3. Phone, email, or both: Question Title * 4. What is the best way to reach you? Text Phone Email U.S. Mail Question Title * 5. Do you use a smart phone, tablet, or computer? Smart phone Tablet Computer Question Title * 6. What type of transportation do you have access to? Bus Taxi Train Support staff, family, or friend Car Limited or none Other (please specify) Question Title * 7. Please list some barriers you face as a parent: Question Title * 8. Are you interested in the future planning of a parents' advocacy group? Yes No Not sure, I want to learn more Question Title * 9. How did you hear about this forum? Mail Email Flyer Word of mouth Text Other (please specify) Done