DC AT Program Public Input Survey 2018

Kindly respond to this survey by April 13, 2018.
 
The Assistive Technology Program for the District of Columbia (ATPDC) is the Districts “Assistive Technology Act” Program.  We need this information to provide high quality and impactful services to meet the assistive technology needs for persons with disabilities, their family members and other interested individuals. We offer 4 key services as indicated below and in order to better understand Washingtonian’s with disabilities needs, we appreciate you taking 5 minutes to complete this important survey.  
 
Assistive technology (AT) includes devices such as hearing aids, electronic magnifiers, adapted software, communication systems, wheelchairs, ramps and much, much more.  AT services include needs evaluations, training and ongoing supports.

Services we provide:

Assistive Technology Resource & Demonstration Center
An opportunity to learn about various assistive technology devices, try them out and discuss their use. 

Assistive Technology Device Loan Program
An avenue to borrow AT devices on a short term basis for trial, evaluation or accommodation.
 
Disability Equipment Recycling Program (DC SHARES)
Provided recycled and new durable medical equipment for residents with low or no income at no cost.
 
Assistive Technology Financing Loan Program (DC FUND$)
Offers an affordable, low interest, alternative funding source to purchase AT devices and services.

Please tell us which of the following categories best describes you:

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* 1. Please tell us which of the following categories best describes you:

Assistive Technology Resource & Demonstration Center
Please check all that apply:

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* 2. Please check all that apply:

I am interested in Assistive Technology Demonstration(s) of:
(Please check all that apply)

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* 3. I am interested in Assistive Technology Demonstration(s) of:
(Please check all that apply)

Assistive Technology Device Loan Program
Please check all that apply:

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* 4. Please check all that apply:

I am interested in borrowing devices related to:
(Please check all that apply)

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* 5. I am interested in borrowing devices related to:
(Please check all that apply)

Disability Equipment Recycling Program (DC SHARES).
Please check all that apply:

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* 6. Disability Equipment Recycling Program (DC SHARES).
Please check all that apply:

I am interested in some of the following equipment:
(Please check all that apply)

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* 7. I am interested in some of the following equipment:
(Please check all that apply)

Alternative Financing Program (DC FUND$)

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* 8. Alternative Financing Program (DC FUND$)

I am interested in purchasing devices related to:
(Please check all that apply)

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* 9. I am interested in purchasing devices related to:
(Please check all that apply)

What is important to you?
Please rank the importance of the following programs
(1) Most Important
(2) Somewhat Important
(3) Less Important
(4) Least Important

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* 10. What is important to you?
Please rank the importance of the following programs
(1) Most Important
(2) Somewhat Important
(3) Less Important
(4) Least Important

What is important to you?
Please rank the importance of the following programs
(1) Most Important
(2) Somewhat Important
(3) Less Important

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* 11. What is important to you?
Please rank the importance of the following programs
(1) Most Important
(2) Somewhat Important
(3) Less Important

What is your age group?

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* 12. What is your age group?

To ensure we are reaching District of Columbia residents from across the state with this survey, in which ward do you live?:

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* 13. To ensure we are reaching District of Columbia residents from across the state with this survey, in which ward do you live?:

If you are aware of the Assistive Technology Program for DC (ATPDC), how did
you learn about us?

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* 14. If you are aware of the Assistive Technology Program for DC (ATPDC), how did
you learn about us?

Please tell us how and/or from whom you got this survey:

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* 15. Please tell us how and/or from whom you got this survey:

Is there anything else you would like to share with us?

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* 16. Is there anything else you would like to share with us?

Thank you for taking the time to complete this questionnaire!! Your answers will help us plan a statewide program that meets the assistive technology needs of Washingtonians with disabilities and older Washingtonians.

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