Family Needs Assessment Survey

You are receiving this survey because your child is registered with the Alaska Deafblind Project. As our project plans upcoming activities, we would like input from families throughout the state to ensure we meet the needs of families and children on our registry.
1.Name of family member completing the survey:(Required.)
2.Email:(Required.)
3.Phone:(Required.)
4.What are the top 3 needs you have for your child (select from the following list or add your own)?(Required.)
5.In what areas do you need to increase your knowledge and skills, or would like training (select all that apply)?(Required.)
6.Are current family training opportunities in your state meeting your needs?(Required.)
7.Please explain how current training opportunities could be improved.
8.What service providers—public or private—have worked with your child in the past?(Required.)
9.What service providers—both public or private—currently work with your child?(Required.)
The next set of questions relate to your experiences with other agencies and organizations that we sometimes refer families to for support and training, as well as the Alaska Deafblind Project. We want to ensure that other agencies and our project are responsive to your needs.
10.Have you sought or received support from the Alaska Deafblind Project?(Required.)
11.What Alaska Deafblind Project supports have been most helpful?(Required.)
12.Do you know about The Anne Freitag Library housed at Special Education Service Agency (SESA)?(Required.)
13.Have you used the Alaska Deafblind Project website? https://sesa.org/services/deaf-blind/(Required.)
14.Do you follow the Alaska Deafblind Project Facebook page?(Required.)
15.Where do you go for information and resources?
16.How would you like information about resources to be presented to you?(Required.)
17.How can we help you access the Alaska Deafblind Project and other local resources?
18.Are you aware of the National Center on Deafblindness (NCDB)?(Required.)
19.Are you presently volunteering for or serving on boards or committees of any local, state, or national organizations? If yes, please list the name of the organization and your role.
20.Are you interested in participating in future advocacy opportunities at the following levels (check all that apply)?(Required.)
21.How many times per month, on average, do you have an opportunity to communicate with another family member of a person who is deafblind?(Required.)
22.Would you like to be connected to other families of children with deafblindness or increase your current connections?(Required.)
23.Are you interested in participating in a family network/support system in collaboration with the Alaska Deafblind Project?(Required.)
24.If interested in participating in a family network, how would you like those interactions to happen?(Required.)
25.Do you feel that you have a good understanding of your child's diagnosis?(Required.)
26.What is your child’s age?(Required.)
27.What is the primary language spoken in your home?
28.Please share any additional comments you have regarding Alaska Deafblind Project and its services.
Thank you for taking the time to respond to this survey. The information will help us in planning future services and activities. If you’d like support from the Alaska Deafblind Project or would like to be connected to other families, contact: Angel Black, M.S.Ed., TSVI, COMS / Alaska Deafblind Project Director / ablack@sesa.org / (907) 334-1300.