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Background Information
Thank you for taking the time to complete this brief survey. Your feedback will enable us to evaluate the current and future services that we are able to offer to you.
What is your child’s age?
(Required.)
What is your child's diagnosis?
(Required.)
Autism
Asperger's Syndrome
PPD - Not Otherwise Specified
Child Disintegrative Disorder
Rett's Syndrome
Other (please specify)
What county do you live in?
(Required.)
Berks
Bucks
Chester
Delaware
Lancaster
Montgomery
Philadelphia
Other (please specify)
17%