Exit this survey >> 2015 PEATC Parent and Youth Summit in Association With DARS Needs Assessment Question Title * 1. Please tell us who is completing this survey. Student Parent of Student Other Other (please specify) Question Title * 2. In what city or county is the school the student attends or attended? Question Title * 3. Please specify the student's gender. Male Female Question Title * 4. What is the student's current age? 14 15 16 17 18 19 20 21 22 23 24 Other (please specify) Question Title * 5. Please specify the student's ethnicity. American Indian Asian/Pacific Islander Hispanic/Chicano/Latino Black (Non-hispanic) White (Non-hispanic) Other (please specify) Question Title * 6. Please check if the student has any of the following disabilities:Check all that apply. Learning disability Emotional disability Physical disability Visual disability Hearing disability Brain Injury Autism Spectrum Disorder Intellectual disability Developmental disability Other Other (please specify) Question Title * 7. Has the student received vocational rehabilitation services from DARS (Department for Aging and Rehabilitative Services)? Yes No Do not know Question Title * 8. Please rate the student's experience with vocational rehabilitation services at DARS. Excellent Good Fair Unsatisfactory Not applicable Question Title * 9. If the student is not working what services would they need to become employed? Check all that apply. Job Coaching Internship/summer work Assistive Technology Job Seeking Skills Training Skills Training Guidance and Counseling from a vocational rehabilitation counselor Job Placement Services Vocational Evaluation Benefits Planning Physical Restoration Mental Restoration Independent Living Skills Training College education Other (please specify) Question Title * 10. Does the student currently have the skills and training to get employed in the community? Yes No Not Applicable Question Title * 11. Are any of the following likely to make it hard for the student to get a job? Yes No Do Not Know Health or physical limitations Health or physical limitations Yes Health or physical limitations No Health or physical limitations Do Not Know Lack of training or education Lack of training or education Yes Lack of training or education No Lack of training or education Do Not Know Problem finding housing Problem finding housing Yes Problem finding housing No Problem finding housing Do Not Know Problem finding transportation Problem finding transportation Yes Problem finding transportation No Problem finding transportation Do Not Know Problem finding child care Problem finding child care Yes Problem finding child care No Problem finding child care Do Not Know Language or cultural barriers Language or cultural barriers Yes Language or cultural barriers No Language or cultural barriers Do Not Know Physical barriers Physical barriers Yes Physical barriers No Physical barriers Do Not Know Question Title * 12. What could DARS do to improve services to students with disabilities? Question Title * 13. Other comments? Done >>