Special Ed: What Parents Need to Know 11.12.2020 Question Title * 1. Please provide your contact information. (Required.) Name Email Address Phone Number Question Title * 2. What county do you live in? Question Title * 3. What is your race? Black or African American White or Caucasian Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Multiple Races Question Title * 4. What is your ethnicity? Hispanic or Latino Non-Hispanic or Latino Question Title * 5. Please provide your child's date of birth. Date of Birth Date Question Title * 6. What is your child's race? Black or African American White or Caucasian Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Multiple Races Question Title * 7. What is your child's ethnicity? Hispanic or Latino Non-Hispanic or Latino Question Title * 8. What is your child's diagnosis? Please check all that apply. Autism ADD/ADHD Deaf/Blind Developmental Delay Intellectual Disability Deaf/Hearing Impairment Emotional Disability Learning Disability Multiple Disabilities Other Health Impairment Orthopedic Impairment Speech & Language Traumatic Brain Injury Vision Impairment/Blind Suspected Disability None Other (please specify) Done