The next seven questions relate to services you are now receiving to help you live independently.

* 3. Of the current services you access in your community, which are the most important for you to continue living independently? Check up to five (5) services.

If you have questions about the meaning of terms used in this list, please see the definition of the terms provided here.

* 4. Where do you go to receive these services? Check all that apply.

* 5. What is the furthest you have to travel each way on a regular basis to receive the above services? (Select only 1.)

* 6. Please select from the list below, the best way(s) for you to communicate with service providers regarding the important services you identified above. (Check all that are most helpful.)

* 7. Please number by importance what would make it easier for you to access services. Use 1 as the most important and 6 as the least important. 

* 8. If you have other suggestions related to question #7, please list them here.