Services & Issues North Country Center for Independence - Plattsburgh, New York Question Title * 1. Please choose up to 5 services that you think are the most needed for people with disabilities in the North Country: Support or social groups Transportation Personal counseling Jobs and career help Business accessibility Help with emergency planning & response Advocacy and problem-solving help Life skills & personal finance training Education help Benefits help Finding and organizing services Nutrition and fitness help Home care Social opportunities Home accessibility Help with assistive technology Other (please specify) OK Question Title * 2. Please choose up to 5 issues or problem areas that you think are the most important for people with disabilities in the North Country: Accessibility of public fairs & festivals Job accessibility & discrimination Voting accessibility & discrimination Housing accessibility & cost Accessibility of public buildings & facilities Lack of accessible & affordable transportation Accessibility of streets & sidewalks Problems with schools & colleges Police & legal problems Problems with home care & support services Accessibility in businesses Problems with service agencies Everyday disability prejudice / ableism Problems with doctors & hospitals Problems with nursing homes & other institutions Sub-minimum wage / sheltered workshops Other (please specify) OK Question Title * 3. What kinds of disabilities do you have? (Check any that apply): Mobility impairment Spinal cord injury Neuromuscular disability Traumatic brain injury / stroke Alzheimer’s disease Hearing impairment or deafness Vision impairment or blindness Speech impairment Amputee Intellectual disability Mental illness Learning disability Use a wheelchair Use crutches, walkers, or other mobility aids Autism / Asperger’s Chronic pain Chronic illness I don’t have a disability I have family member who has disabilities I work with people who have disabilities Other (please specify) OK Question Title * 4. Check any of the following that apply to you: Male Female Transgender Gay / Lesbian White Black Native American / Pacific Islander Hispanic / Latinx Asian Age 0-17 Age 18-30 Age 31-50 Age 51-65 Age 65 or older OK DONE - THAN YOU!