Thank you for your participation in this survey. One survey needs to be submitted for each designated HCBS site your agency operates. Questions should be answered specific to your site's operations and not specific to operations in response to the COVID pandemic. Please submit answers to ALL questions by December 31, 2020

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* 1. What is the name of the agency? 

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* 2. Please provide the address of the HCBS site for which you are completing this survey.

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* 3. Please provide contact information for the individual completing this survey.

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* 4. Please list all locations where the HCBS is provided.

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* 9. Please check any of the following setting(s) that may apply to your site.

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* 51. Please enter any comments to provide further information pertaining to above answers. 

0 of 51 answered
 

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