Thank you for your interest in participating in a focus group on decision making for people with disabilities. All focus groups will occur online through a video conference. You must have access to internet and a computer  with microphone and camera to participate.

Please fill out the survey below. We will contact you if you qualify. Dates for the focus groups will be scheduled May 2019. 

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* 1. Name

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* 2. Phone

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* 3. Email

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* 4. The Tennessee county I live in is:

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* 5. The area I live in is:

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* 6. My annual household income is:

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* 7. I identify my gender as:

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* 8. My age is:

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* 9. My race/ethnicity is: (Check all that apply)

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