Community Needs Assessment Survey

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* 1. What county in Georgia do you live or work in?

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* 2. What best describes the population you represent or serve? (Select all that apply)

Infants & toddlers (0-3)

Children (4-12)

Youth (13-17)

Young Adults (18-26)

Adults (27+)

Families/Individuals in rural areas

Families/Individuals in urban/suburban areas

Other (please specify)

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* 3. To ensure that we are serving all populations, what race/ethnicity best describes you? (Please choose only one)

American Indian or Alaska Native

Asian

Black or African American

Hispanic

White/Caucasian

Native Hawaiian/Pacific Islander

Multiple ethnicities

I prefer not to answer

Other (please specify)

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* 4. How important are the following areas for Parent to Parent of Georgia's work?

	Essential	Very Important	Important	Slightly Important	Not Important
Helping famlies/individuals navigate education systems (IEPs, school supports)	Helping famlies/individuals navigate education systems (IEPs, school supports) Essential	Helping famlies/individuals navigate education systems (IEPs, school supports) Very Important	Helping famlies/individuals navigate education systems (IEPs, school supports) Important	Helping famlies/individuals navigate education systems (IEPs, school supports) Slightly Important	Helping famlies/individuals navigate education systems (IEPs, school supports) Not Important
Helping families/individuals navigate health systems (doctors, specialists, insurance)	Helping families/individuals navigate health systems (doctors, specialists, insurance) Essential	Helping families/individuals navigate health systems (doctors, specialists, insurance) Very Important	Helping families/individuals navigate health systems (doctors, specialists, insurance) Important	Helping families/individuals navigate health systems (doctors, specialists, insurance) Slightly Important	Helping families/individuals navigate health systems (doctors, specialists, insurance) Not Important
Training and workshops for families/individuals	Training and workshops for families/individuals Essential	Training and workshops for families/individuals Very Important	Training and workshops for families/individuals Important	Training and workshops for families/individuals Slightly Important	Training and workshops for families/individuals Not Important
Peer-to-peer support and mentoring	Peer-to-peer support and mentoring Essential	Peer-to-peer support and mentoring Very Important	Peer-to-peer support and mentoring Important	Peer-to-peer support and mentoring Slightly Important	Peer-to-peer support and mentoring Not Important
Transition to adulthood (employment, college, independent living)	Transition to adulthood (employment, college, independent living) Essential	Transition to adulthood (employment, college, independent living) Very Important	Transition to adulthood (employment, college, independent living) Important	Transition to adulthood (employment, college, independent living) Slightly Important	Transition to adulthood (employment, college, independent living) Not Important
Supporting culturally and linguistically diverse families/individuals	Supporting culturally and linguistically diverse families/individuals Essential	Supporting culturally and linguistically diverse families/individuals Very Important	Supporting culturally and linguistically diverse families/individuals Important	Supporting culturally and linguistically diverse families/individuals Slightly Important	Supporting culturally and linguistically diverse families/individuals Not Important
Mental and behavioral health supports	Mental and behavioral health supports Essential	Mental and behavioral health supports Very Important	Mental and behavioral health supports Important	Mental and behavioral health supports Slightly Important	Mental and behavioral health supports Not Important
Advocacy at state and local levels	Advocacy at state and local levels Essential	Advocacy at state and local levels Very Important	Advocacy at state and local levels Important	Advocacy at state and local levels Slightly Important	Advocacy at state and local levels Not Important

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* 5. How well do you think Parent to Parent of Georgia currently addreses these areas?

	Very Well	Well	Fairly Well	Poor	Very Poorly
Helping families/individuals navigate education systems (IEPs, school supports)	Helping families/individuals navigate education systems (IEPs, school supports) Very Well	Helping families/individuals navigate education systems (IEPs, school supports) Well	Helping families/individuals navigate education systems (IEPs, school supports) Fairly Well	Helping families/individuals navigate education systems (IEPs, school supports) Poor	Helping families/individuals navigate education systems (IEPs, school supports) Very Poorly
Helping families/individuals navigate health systems (doctors, specialists, insurance)	Helping families/individuals navigate health systems (doctors, specialists, insurance) Very Well	Helping families/individuals navigate health systems (doctors, specialists, insurance) Well	Helping families/individuals navigate health systems (doctors, specialists, insurance) Fairly Well	Helping families/individuals navigate health systems (doctors, specialists, insurance) Poor	Helping families/individuals navigate health systems (doctors, specialists, insurance) Very Poorly
Training and workshops for families/individuals	Training and workshops for families/individuals Very Well	Training and workshops for families/individuals Well	Training and workshops for families/individuals Fairly Well	Training and workshops for families/individuals Poor	Training and workshops for families/individuals Very Poorly
Peer-to-peer support and mentoring	Peer-to-peer support and mentoring Very Well	Peer-to-peer support and mentoring Well	Peer-to-peer support and mentoring Fairly Well	Peer-to-peer support and mentoring Poor	Peer-to-peer support and mentoring Very Poorly
Transition to adulthood (employment, college, independent living)	Transition to adulthood (employment, college, independent living) Very Well	Transition to adulthood (employment, college, independent living) Well	Transition to adulthood (employment, college, independent living) Fairly Well	Transition to adulthood (employment, college, independent living) Poor	Transition to adulthood (employment, college, independent living) Very Poorly
Supporting culturally and linguistically diverse families/individuals	Supporting culturally and linguistically diverse families/individuals Very Well	Supporting culturally and linguistically diverse families/individuals Well	Supporting culturally and linguistically diverse families/individuals Fairly Well	Supporting culturally and linguistically diverse families/individuals Poor	Supporting culturally and linguistically diverse families/individuals Very Poorly
Mental and behavioral health supports	Mental and behavioral health supports Very Well	Mental and behavioral health supports Well	Mental and behavioral health supports Fairly Well	Mental and behavioral health supports Poor	Mental and behavioral health supports Very Poorly
Advocacy at state and local levels	Advocacy at state and local levels Very Well	Advocacy at state and local levels Well	Advocacy at state and local levels Fairly Well	Advocacy at state and local levels Poor	Advocacy at state and local levels Very Poorly

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* 6. Please select the role that best describes you:

Parent/Caregiver or Support Person of a child or young adult with a disability or special health care need

Professional (educator, healthcare provider, social service etc.)

P2P Board Member

Funder/Policy Stakeholder

Self-Advocate