What moves you?

 This is a brief survey to better understand and meet the needs of individuals living with disabilities. Any information we receive will be kept strictly confidential.

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* 1.  Which of the following best describes you?

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* 2. What type of disability do you live with?  Please select all that apply.

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* 3.  What type of transportation do you rely on?

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* 4. What county do you live in?

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* 5. How many hours per week do you work?

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* 6.  How many hours a week do you spend outside your home doing recreational activities?

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* 7. Do you  do any recreational activities or play any sports? Please select all that apply.

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* 8. Are you interested in  doing any of these recreational activities or playing any of the following sports?  Please select all that apply. 

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* 9.  Would you be willing to volunteer  with recreational and sports activities? Please select the one that best suits you. 

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* 10.  What limits you most from doing the activities that you want to do? 

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