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Advocate Action Survey
Thank you for participating in our Advocacy Campaign in support for people with I/DD. Please complete the brief survey below to help us track our advocacy outreach across the state.
1.
Chapter or agency affiliation (if any)
2.
Why are you invested this advocacy campaign? (check all that apply)
Family Member
Self Advocate
Staff
Community Member
Other (please specify)
3.
Name of state leader(s) engaged
4.
How did you engage them (check all that apply)
In person
Over the phone
Via email
Other (please specify)
5.
Was the feedback from the legislator:
Positive
Negative
Mixed
Unsure
Please share specific feedback or comments
6.
Please share your contact information to engage in future campaigns (optional)
Name
Email address
7.
General comments, stories shared, feedback from participants, etc.
