Parent Survey Parent Name* First Name Last Name Email* Phone* Child’s age* School your child attends* District* My child has the following: Individualized Education Plan (IEP) Individualized Family Service Plan (IFSP) 504 Plan Child’s disability (optional) We live in an area with access to public transportation:* Yes No What are the most impactful accessibility barriers that your child faces in the community?* Agencies that you/your child are currently receiving services from:* (examples: Board of Developmental Disabilities, Opportunities for Ohioans with Disabilities- OOD, Harbor, etc.) What services is your child currently receiving from these agencies?* What services do you feel your child could benefit from, but is not currently receiving?* When your child was diagnosed, did you receive education or resources regarding the diagnosis?* Yes No If yes, from whom: When your child was diagnosed, would you describe it as a positive experience? Yes No Comments about your diagnosis experience Does your child use assistive technology?* Yes No If yes, what kind? Mark the services you feel are lacking in the community for youth and young adults with disabilities:* Recreation and leisure Peer support/social opportunities Transition services Summer Programming Parent Education IEP support Employment Independent living Before/After School Care Services for children ages 0-12 Support for families Other Other What are your greatest concerns for your child?* My child needs services or goals in the following areas:* Recreation/leisure Family services/resources Transition Future planning Self-advocacy Employment Independent living Other Other Does your child need additional training?* Yes No If yes, mark the areas that apply: Personal Safety Disaster Preparedness Establishing Boundarie Financial Management Employment Pre-employability Self-advocacy Cooking and Nutrition Sex Education Wellness and Healthy Lifestyles Volunteering Leadership Other Other Are you aware of the various types/levels of guardianship?* Yes No Are you aware of the other options available in lieu of guardianship?* Yes No Are you interested in parent workshops?* Yes No If yes, list the topics below: What resources/agencies have been most helpful to you as a parent? I would like to receive information via: Flyers/postcards Mail Email Events/Presentations Facebook Page Phone This field is for validation purposes and should be left unchanged.