PDC: Rural Needs Survey

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Your name (optional, but what the heck):

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Your email address (please do so we can add you to our rural data base):

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What Region do you work in?

Region 1

Region 2

Region 3

Region 4

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What county do you provide services in?

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What rural issues would you identify which influence both you and your client when working together in a rural setting?

A.

B.

C.

D.

E.

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If you have specific comments about the issues you listed, please do so here:

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In a sharing mood?
Please share any thoughts you may have about our NCTASC Rural Project!