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1. Please rank each of the indicator categories from most to least important for you/your child to have a positive healthcare experience.

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2. In your opinion, which of the six indicator categories do you think healthcare is currently doing well with?

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3. In your opinion, which of the six indicators categories has the most room for improvement in healthcare settings?

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4. What comments or input do you have for Training Quality Indicators?

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5. What comments or input do you have for Communication Needs Indicators?

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6. What comments or input do you have for Physical Space Indicators?

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7. What comments or input do you have for Challenging Behavior Quality Indicators?

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8. What comments or input do you have for Delivery of Care Indicators?

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9. What comments or input do you have for Administration and Culture Indicators?

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10. If you feel we've missed any important categories, please list what you would add.

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11. If you feel we've included any unnecessary or unhelpful categories, please list what you would remove.

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12. Give an example of something you’ve experienced that worked well for you/your child that you recommend more places/providers do.

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13. Based on the overview we provided, please provide any additional input you have on our Autism-friendly Healthcare Practices Self-assessment and Quality Improvement Tool

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