All responses shared in this survey are CONFIDENTIAL. The information provided will be stored separately from any other vendor information and used for the sole purpose of communication for these specific activities.  

Question Title

* 1. Are you currently a provider with the Regional Center of the East Bay?

Question Title

* 2. What county/counties do you provide services? 

Question Title

* 3. What type of services do you provide? (You may select more than one)

Question Title

* 4. RCEB will be conducting a series of focus groups/listening sessions to understand the experiences of service providers in our community, especially those from communities of color. Would you be interested in participating in a focus group?

Question Title

* 5. What is the best time of day for you to meet to participate in a focus group? 

Question Title

* 6. Which location would you prefer to participate in a focus group? 

Question Title

* 7. Do you have staff that is fluent in any of the languages listed (you may select more than one):

Question Title

* 8. What race do you identify with? (Check more than one box if needed)

Question Title

* 9. As a service provider, what race/ethnicity do you identify your organization with? Please answer with reference to the board or executive leadership team.

Question Title

* 10. Does the above response represent the agency's board or executive leadership team?

Question Title

* 11. Please provide us with the following so we can reach you:

Question Title

* 12. If you would like to make any comments or inquiries, please provide them below:

0 of 12 answered
 

T