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* 1. Check the description that best describes you or the person you are answering for:

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* 2. Check the box or boxes that best describe your disability or that of the person you are answering for:

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* 3. In the past year, what has been the biggest challenge related to your disability, that has limited your independence and/or participation in the community?

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* 4. If you were able, what change would you make in Idaho to improve life for people with disabilities?

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* 5. What changes could Centers for Independent Living or other disability programs make to better support people with disabilities with their independence?

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* 6. Age:

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* 7. Please enter your zip code.

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