As ACCESS to Independence works to improve access to peer support, we are interested in knowing if people with disabilities, and their families, friends, and supporters, are interested in participating in any groups, events, or activities where people can get together to have fun, provide mutual support, learn new things, or work on issues together.

Please take a few moments to share with us what activities might interest you, or someone that you support. We will share the results in the New Year, and plan to develop some peer activities for 2020 based on the results of the survey.

We also plan to provide the community with more information about existing groups and activities being offered by other organizations throughout our service area, so people will have information about and access to additional opportunities to come together

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* 1. I am a

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* 2. My age is

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* 3. I live in

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* 4. Please check any groups or events that you, or someone you support might be interested in attending at ACCESS or other places in the community if hosted by ACCESS

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* 5. What two times a day would you, or the person you support, be most interested in attending group or events?

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* 6. Where would you, or the person you support, be most interested in attending groups or events (Please check all that apply)

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* 7. I believe that there are enough support groups, social and learning activities available for people with disabilities in my area

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* 8. I would like more information about disability or interest specific support of social groups there are available for people with disabilities in my community 

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* 9. I would  like to help start a support or social group for people who share my hobbies or interests, or those of someone that I support, in my community 

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* 10. I would like to help start a support or social group for people who share my hobbies or interests, or those of someone that I support, in my community.

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* 11. I would like to help start an advocacy group for people with disabilities and their allies to work on important issues in my community.

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* 12. I am interested in volunteering to provide one-on-one peer support to someone else with a disability.

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* 13. If you answered “YES” or that you might consider it to any of the questions above, PLEASE PROVIDE US WITH YOUR NAME AND CONTACT INFORMATION so that we can follow up with you.

THANK YOU for sharing your opinions and ideas with us!

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