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* 1. Please provide your full name.

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* 2. Please specify the date when you filed the OCR complaint.

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* 3. What is the reference number of your OCR complaint, if available?

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* 4. What was the main issue addressed in your OCR complaint?

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* 5. How long have you been waiting for a response to your complaint?

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* 6. What steps have you taken since filing the complaint? Select all that apply.

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* 8. Please provide your contact number.

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* 9. Please check yes if a representative from The Arc can contact you with follow up questions.

Thank you for your participation with this survey! Responses will be sent to our federal chapter for review. If more information is needed, they will reach out to you directly. If you have any questions, you can email The Arc of New Jersey at education@arcnj.org.

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