* 1. Getting around  maybe difficult, what problems have you encountered?

* 2. What services or areas of life are you having the most difficulty with, (Social Security, Vocational Training, employment, transportation, healthcare, adequate food, training, recreation, etc.)

* 3. What would make your daily life activities  easier?

* 4. When identifying a barrier, would you be willing to advocate for change?

* 5. Advocating for change comes best from those who will most benefit from it, what we can do to help you become a better advocate for yourself?

* 6. Please let us know where you live.

* 7. Have you experienced any architectural or attitudinal barriers in your daily life?

* 8. Is there anything else that you would like to add?