"Support, Encouragement, Empowerment"

Needs Assessment

Step 1
I am usually looking for resources for the following type of disability:



Step 2
I am generally satisfied with the range of supportive services available for people with disabilities in the Lewis/Thurston/Mason County area.
Strongly Agree  Somewhat Agree Somewhat Disagree Strongly Disagree
Step 3
I (or my family member/friend) currently use the following services:



 
Step 4
What is the farthest distance (round trip) you have to travel to access the services you are currently using?
Less than 20  20-40 miles 40-60 miles 60-80 miles 80-100 miles
More than 100 miles
Step 5
How often do you have to drive outside the Lewis/Thurston/Mason County area to access the services you are currently using?
Once a week  Once a month  More than once a month More than twice a year Less than once a year
Step 6
If you were able to access the following services appropriate to your disability in the Lewis/Thurston/Mason County area, which services would you use?



 
Step 7
If I were going to use the services listed in Question 6, the services would be paid for with:

 
Step 8
If the following opportunities were available at low cost or no cost in the Olympia/Lacey/Tumwater area, which ones would you be likely to use?



 
Step 9
I really wish I had help to:



 
Step 10
Person completing this survey is a:

Step 11
I (or my family member/friend) live in:
Step 12
I (or my family member/friend) live in:


Contact Information
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