INSILC Feedback Form INSILC collects feedback from people with disabilities across Indiana to create statewide projects that advances independent living and fully integrated community life for all. Question Title * 1. Are you a person with a disability? Yes No Prefer Not To Answer Question Title * 2. In which county do you live? Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur DeKalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hancock Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Jennings Johnson Knox Kosciusko LaGrange Lake LaPorte Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush St. Joseph Scott Shelby Spencer Starke Steuben Sullivan Switzerland Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley Question Title * 3. Do you identify as any of the following? (Select all that apply.) Racial/ethnic minority Rural Resident Veteran Youth Question Title * 4. Are your needs being met? Question Title * 5. Do you have access to the services you need? Question Title * 6. Are there resources you wish were available? Question Title * 7. What challenges do you face? Question Title * 8. Is there anything else that you would like to tell us? Thank you for leaving your feedback! You can see all of the responses we have received at insilc.org/feedback/. Done
