Ohav Shalom Inclusion Survey

* 1. Do you or an adult family member or child identify as a person with a disability?

* 2. If you are filling this out for a family, how many children and/or adults do you represent?

* 3. Which of the following have you or a family member used at Ohav Shalom?

* 4. Does Ohav Shalom currently foster an atmosphere where you feel comfortable sharing information about your own or a family member’s needs or asking for accommodations? If not, why?

* 5. Have you or a family member felt comfortable asking for accommodations or assistance (when needed) from Ohav Shalom congregants and/or staff while you participated in social or religious functions at the synagogue? 

* 6. If you haven't been comfortable asking for accommodations or disclosing needs, what can Ohav Shalom do to make you more comfortable? Please elaborate. 

* 7. Religious services would be more accessible and meaningful to me and/or a family member if . . . . (check all that apply)

* 8. Events in the social hall (for example, Kiddush luncheon, the community Seder, or congregational meetings) would be more accessible to me and/or a family member if . . . . (check all that apply)

* 9. If you are a professional who works with or has worked with children and/or adults with disabilities, please specify if you are a physician, teacher, therapist, counselor or service provider, and if you would like to lend your services to the congregation on occasion.

* 10. If you have difficulty participating in other synagogue activities, please let us know why. If you would be open to a confidential conversation on this topic, be sure to provide contact information at the end of the survey.

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