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City of Tolleson Disability Awareness Training Needs Assessment 2023
11.
Thank you for your time
In preparation for upcoming training, please take a few minutes to complete the following survey. Your responses will be completely confidential.
1.
What is your job title/role?
2.
Please respond to the following based on the level of contact you have/have had with individuals with the list of disabilities then your level of comfort. Your answers are Completely Confidential.
Level of Contact
Level of Comfort
Autism Spectrum
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Cerebral Palsy
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Epilepsy (including epilepsy first aid)
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Hearing Loss-Deaf (use mainly sign language)
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Hearing Loss-Hard of Hearing
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Intellectual or Learning Disabilities
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Mobility Loss (upper & lower mobility)
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Psychiatric Disabilities
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Service Dogs (Real or questionable)
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Speech Disabilities (speech impediments)
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Vision Loss
-- Select an option --
Unknown
No contact
Little contact
Some contact
A lot of contact
-- Select an option --
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
Other Comments:
3.
If you've assisted a resident and/or co-worker with a disability, please share how you effectively worked with them and/or what you might do differently next time.
4.
What question(s) would you like answered or issues discussed related to most effectively serving and/or working with those with disabilities?
