Adults on the Spectrum Survey

This survey is designed to help the Autism Society of Nebraska gain important information from autistic adults about their views on helpful and needed support groups and activities in Nebraska. It takes between 5-10 minutes to complete.

This survey is anonymous unless you decide to provide your information at the end.

*1.Please choose the best option:(Required.)

I am an Autistic Adult

I am a caregiver or parent of an Autistic Adult. I am filling out this survey on their behalf. All responses, including demographic answers, represent the individual on the spectrum.

Other:

*2.What is your age?(Required.)

18-21

22-30

31-40

41-50

51-60

61+

Other

*3.What is your current relationship status?(Required.)

Single

In a Relationship

Married

Separated

Divorced

Widowed

Other:

*4.Do you have children?(Required.)

Yes

Other:

*5.What is your employment status? (Select all that apply at this time)(Required.)

Employed by an employer

Self employed

Student

Unemployed but currently looking for work

Unemployed and not looking for work

Unable to work

Day Program or Employment Initiative

Homemaker

Retired

If you are working, in a day program or a student: How many hours per week?

*6.Where in Nebraska do you live?(Required.)

*7.What is your modes of transportation? (Select all that apply at this time)(Required.)

I drive my own car

Someone else drives me

I take public transportation

I bike

I walk

Taxi, Uber, Lyft

What is your primary mode of transportation?

*8.Have you participated in a support group in the past?(Required.)

Yes

Other:

Create surveys and forms with ease. Sign up free.

Privacy & Cookie Notice