2021 Self-Advocate and Family Member Survey

Are you a person with a disability or a family member? Did you take part in an activity by the Wisconsin Board for People with Developmental Disabilities (WI-BPDD) during this past year? If so, please take our short survey. This survey helps us understand the impact our activities have on people's lives.

If you have already completed the survey this year, please do not complete it again.

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* 1. During the past year which of the following WI-BPDD activities have you participated in? (Check all that apply)

People First activities

COVID-19 activities

Living Well activities

Partners in Policy Making

Youth Leadership Forum

Sparks Grants

Employment First Partner Grants

Building Full Lives

Partners with Business

Take Your Legislator to Work

Supported Decision Making

Family-Led or Family Navigator Project

Self-Determination Conference

Employment First Conference

Voting Trainings

Disability Advocacy Day

Grassroots State or Federal Advocacy (i.e. took action on an issue brought to my attention by WI-BPDD)

Social Media (i.e. follow WI-BPDD on social media and share content with others in my network or follow Living Well Wednesdays or the Self-Determination YouTube Channel)

Other (please specify)

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* 2. Were you satisfied with the WI-BPDD activity that you participated in during the past year?

Yes

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* 3. Is your life better as a result of participating in a WI-BPDD activity during the past year?

Yes

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* 4. Please share a story about how participating in WI-BPDD activities has made your life better.

As a result of participating in a WI-BPDD activity...

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* 5. I have (check all that apply):

Voted or registered to vote.

Gotten a COVID vaccine or encouraged someone else to.

Gotten a job in the community or increased my hours on the job.

Gotten more involved in my community.

Used Supported Decision-Making tools to avoid or lessen the limits resulting from guardianships.

Gotten connected to other people with disabilities or families to learn about resources and to network.

Increased my natural supports (the number of people, other than paid professionals, who help or support me).

None of the above.

Other (please describe)

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* 6. I feel more confident that I can (check all that apply):

Stay safe and healthy.

Report abuse and neglect if I experience it or if someone else is.

Make my own decisions.

Have a job in the community that pays minimum wage or higher.

Live on my own with the support I need.

Have a plan for my future and my loved one's future.

Be a leader in my community.

None of the above.

Other (please describe)

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* 7. I have increased my advocacy.

Yes

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* 8. I am better able to say what I want.

Yes

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* 9. I am now participating in advocacy activities.

Yes

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* 10. I am now on an advisory board, committee and/or serving in a leadership position (such as People First, a parent/teacher organization, a community board, etc.)

Yes

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* 11. Please tell us whether you are:

A person with a disability

Family member of a person with a disability

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* 12. Please tell us whether you are:

American Indian and Alaska Native

Asian

Black or African American

Hispanic/Latino

Native Hawaiian and other Pacific Islander

White or Caucasian

Two or more races

Race unknown

Prefer not to answer

Other (please specify)

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* 13. Do you identify as:

Female

Male

Non-binary

Prefer not to say

Prefer to self-describe

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* 14. Which of the following best describes the area that you live in?

Rural

Urban/Suburban

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* 15. Please provide the following information (optional):

Name:

Address:

City/Town:

ZIP:

Email Address:

Phone Number: