SurveyMonkey Powered Online Survey

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* 1. Who are you? (check the box that best describes you)

Person with a disability (self-advocate)

Family member of a person with a disability

Service Coordinator or Provider

Direct Support Staff

School Administrator or Special Education Director

Teacher (Regular or Special Education)

Physician, Nurse, or other licensed health care provider

Judge or Attorney

Guardian and/or Conservator

Other (please specify)

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* 2. In what Kansas county do you work and/or reside?

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* 3. What information about guardianship or alternatives to guardianship would you find most valuable? (check all that apply)

General information about guardianship

Alternatives to guardianship (what they are and how to get them)

Tools that will assist in determining whether a person needs a guardian

A guardian's legal rights and responsibilities

A ward's (a person who has a guardian) legal rights and responsibilities

How to file for guardianship of an individual

How to challenge or prevent a guardianship

How to have a guardianship removed after one has been ordered

Other (please specify)

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* 4. Has someone said that you or someone you know needs a guardian? If so, who gave you that advice?

A guardian or conservator

A school official and/or teacher

A disability advocacy organization and/or staff

A service coordinator or provider

A direct support staff

A physician, nurse, or other licensed health care professional

An attorney or judge

A friend or family member

Other (please specify)

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* 5. If you've been told that you or someone you know needs a guardian, please indicate below whether you agree, disagree, or are not sure:

	TRUE	FALSE	NOT SURE
Guardianship is needed in order to select, hire, and fire staff for an individual	Guardianship is needed in order to select, hire, and fire staff for an individual TRUE	Guardianship is needed in order to select, hire, and fire staff for an individual FALSE	Guardianship is needed in order to select, hire, and fire staff for an individual NOT SURE
Guardianship is needed in order to help keep an individual and his/her money safe	Guardianship is needed in order to help keep an individual and his/her money safe TRUE	Guardianship is needed in order to help keep an individual and his/her money safe FALSE	Guardianship is needed in order to help keep an individual and his/her money safe NOT SURE
Guardianship is needed to help the individual get and keep a job	Guardianship is needed to help the individual get and keep a job TRUE	Guardianship is needed to help the individual get and keep a job FALSE	Guardianship is needed to help the individual get and keep a job NOT SURE
Guardianship is needed to determine where an individual will live and place them in the most appropriate setting	Guardianship is needed to determine where an individual will live and place them in the most appropriate setting TRUE	Guardianship is needed to determine where an individual will live and place them in the most appropriate setting FALSE	Guardianship is needed to determine where an individual will live and place them in the most appropriate setting NOT SURE
Guardianship is needed in order to determine what services an individual will receive	Guardianship is needed in order to determine what services an individual will receive TRUE	Guardianship is needed in order to determine what services an individual will receive FALSE	Guardianship is needed in order to determine what services an individual will receive NOT SURE
Guardianship is needed in order to make health care decisions for an individual	Guardianship is needed in order to make health care decisions for an individual TRUE	Guardianship is needed in order to make health care decisions for an individual FALSE	Guardianship is needed in order to make health care decisions for an individual NOT SURE
Guardianship is needed to prevent an individual from being taken advantage of	Guardianship is needed to prevent an individual from being taken advantage of TRUE	Guardianship is needed to prevent an individual from being taken advantage of FALSE	Guardianship is needed to prevent an individual from being taken advantage of NOT SURE
Guardianship is necessary when an individual turns age 18 if they are determined by a doctor to have a medical condition whereby they are considered an adult with an impairment, diminished capacity, or mental illness	Guardianship is necessary when an individual turns age 18 if they are determined by a doctor to have a medical condition whereby they are considered an adult with an impairment, diminished capacity, or mental illness TRUE	Guardianship is necessary when an individual turns age 18 if they are determined by a doctor to have a medical condition whereby they are considered an adult with an impairment, diminished capacity, or mental illness FALSE	Guardianship is necessary when an individual turns age 18 if they are determined by a doctor to have a medical condition whereby they are considered an adult with an impairment, diminished capacity, or mental illness NOT SURE

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* 6. Have you experienced or observed guardianship success and/or difficulty? If so, describe your experience or observation below (please be specific without using names or other personally identifiable information):

Experiences where guardianship has been successful include:

What do you think made the above successful?

Experiences where guardianship has not been successful or has encountered significant difficulties:

What do you think caused the above failure(s) and/or difficulties?

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* 7. What are your top three (3) concerns or questions about guardianship:

No. 1

No. 2

No. 3

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* 8. What kind of information on guardianship would you find most helpful?

On-site trainings (conducted by an instructor(s) at a specific place/time)

Webinars (trainings online led by an instructor(s) on a specific day/time)

Publications and/or study materials (paper, online, and/or electronic copies)

Online courses (trainings you can access online anytime)

Other (please specify)

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* 9. Are there additional comments or concerns about Kansas guardianship you'd like to share? If so, please provide them here:

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* 10. If you'd like KCDD to provide you with the findings of this survey and/or future surveys, trainings, and educational information on Kansas Guardianship, please provide your full name and contact information below. (optional)

First and Last Name

Organization and Title/Position

City/Town

Email Address

Phone Number