Thank you for your time to provide important feedback for our adaptive programming! If you are a caregiver filling out on behalf of a participant, please answer as the participant unless otherwise stated.

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* 1. I am:

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* 2. My age group/my participant's age group is: 

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* 3. In my everyday life, I utilize the following adaptive equipment:

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* 4. I most require adaptive programming due to (select all that apply):

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* 5. What motivates you to participate in the adaptive programs (select all that apply):

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* 6. Generally, the best days of the week for me to participate are (select all that apply): 

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* 7. Generally, the best times of the day for me to participate are (select all that apply):

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* 8. I am:

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* 9. I most recently participated in adaptive programs during: 

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* 10. If you have not recently participated in programs, was it due to (choose all that apply): 

(Leave blank if you have participated)

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* 11. When I attend/plan to attend programs, I have a 1:1 assistant or caregiver accompany me:

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* 12. When I attend/plan to attend programs, I am transported by:

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* 13. When adaptive programs were running in person, I attended programs (choose all that apply):

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* 14. When adaptive programs were running in person, I regularly participated in (choose all that apply):

The following questions will ask you to provide feedback on programs which you have participated with in the PAST.

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* 15. I enjoyed the programs I have participated with in the past: 

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* 16. I thought the programs I attended in the past were well organized:

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* 17. I thought the days/times of the program offerings fit my life well:

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* 18. I would have liked to participate in programs more frequently: 

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* 19. If the programs I participated with in the past were offered again, I would sign up to participate again:

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* 20. In the past, I have participated in non-adaptive programming through Troy Recreation with ADA accommodations:

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* 21. Please list anything specific that you enjoyed about past programs: 

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* 22. Please list anything you found frustrating, challenging, or did not enjoy about past programs:

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* 23. Please provide any additional feedback on past programs:

The following questions will ask you to provide feedback/ideas on NEW programs that you might like to see offered in the future.

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* 24. Generally, I would like to see more program offerings related to (select all that apply): 

Please consider the following adaptive programs or program categories. 
Select all that you might have interest participating with if offered in the future:

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* 25. Sports/Fitness/Movement

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* 26. Arts/Crafts/Expression

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* 27. Community Exploration

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* 28. Technology

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* 29. Social/Educational

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* 30. Please provide any additional feedback/ideas or considerations on NEW programs you would like to see offered:

The following information is optional to provide. 

If you do not wish to provide the following information, please select "Done" at the end of this survey.

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* 31. You may contact me further with additional questions related to this survey:

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* 32. Please add me to the newsletter, or future mailings:

Thank you for your time to complete this survey!

All answers will be reviewed by our Recreation Supervisors in hopes of providing you with the best possible adaptive programming.

Please feel free to contact us with any additional comments, questions, suggestions, or concerns at adaptive@troymi.gov

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