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How Can We Help?
We Want To Know What You Think
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1.
What type of assistance are you looking for in the Autism/Special Needs Community?
(Required.)
Access to occupational therapy
Access to speech therapy
Access to music therapy
Access to art therapy
Access to alternative medicine such as a holistic medical practitioner or herbalist/naturopathic doctor
Access to a relevant psychologist, clinical psychologist or mental health specialist for myself, my household and/or special needs family member
More social functions for special needs persons
More inclusive programs closer to my living area
An advocacy group in my local community
Help with obtaining SSI, Medicaid/Medicare for my disabled household member(s) under 18 y/o
Legal advise on obtaining guardianship for my minor disabled household member(s)
Other (please specify)
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2.
If enrolled in school, are you satisfied with the quality of instruction your student(s) is receiving in school?
(Required.)
Yes - Public School
No - Public School
Yes - Private School
No - Private School
Does not apply - Not School Age
Does not apply - Aged out of school
We Homeschool
3.
If not, why? What was your/their experience like? (Optional)
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4.
If enrolled in school, is there an I.E.P. presently being implemented?
(Required.)
Yes
No
We just started the process of acquiring one
I don't know what an I.E.P is, but would like to find out more
5.
What type of changes do you want to see in the special needs community and/or school system?
6.
Is there a particular topic regarding Autism/ Special Needs you'd like to see discussed or changed?
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7.
Are you familiar with what Assistive Technology is?
(Required.)
Yes
No
Familiar - but would like to learn more
8.
What Assistive Technology are you using, digitally or otherwise, at home or school? Is it helpful? Are you looking for alternatives to what you're currently using?
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9.
Do you reside in Virginia?
(Required.)
Yes
No
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10.
Do you reside in Prince William County, VA?
(Required.)
Yes
No
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11.
Are you located within the DC Metro Area?
(Required.)
Yes
No
12.
Can we add you to our mailing list and stay in touch? Optional
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City/Town
State/Province
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