Missouri Statewide Independent Living Council (MOSILC) Needs Assessment (2024)

Demographics

MOSILC has developed this Community Needs Assessment to gather information about your community’s opinions, needs, and challenges for people with disabilities. It is MOSILC’s hope that by gathering this information it will provide MOSILC with important information on how to support people with disabilities within your community.

Question Title

* 1. What is your relationship to the Center for Independent Living (CIL)?

CIL Staff

CIL Volunteer

CIL Board Member

Person with a disability

Family member/friend

Community Partner

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* 2. Center Name

Question Title

* 3. Missouri County

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* 4. Your 5 Digit Zip Code (Use CIL Zip code if not indicated.)

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* 5. What is your age?

Under 5 years old

Age 5 to 19

Age 20 to 24

Age 25 to 59

Age 60 or Older

Unknown

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* 6. What is your gender?

Male

Female

Non-Binary

Prefer not to answer

Other (Please specify)

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* 7. What is your race?

American Indian or Alaska Native

Asian or Asian-American

Black or African-American

Native Hawaiian or Other Pacific Islander

White/Caucasian

Other

Prefer not to answer

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* 8. What is your ethnicity?

Hispanic or Latino

Not Hispanic or Latino

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* 9. What is the your primary disability?

Cognitive

Hearing

Mental/Emotional

Other

Physical

Vision

None