Needs Assessment - Freedom Resource Center

What services or programs do individuals with disabilities need that are not offered or what areas do you feel that people are underserved in?*

What Barriers, if any, do you or the individuals you know or work with, face which make it hard to be independent?

(Rate top 3 most important, 3 being the most important)

Lack of Educational Opportunities

1
2
3

Employment & Vocational Barriers

1
2
3

Public Attitudes/ Discrimination

1
2
3

Transportation

1
2
3

Personal Attendant Services

1
2
3

Lack of Knowledge of Services

1
2
3

Individual Attitudes

1
2
3

Physical Barriers

1
2
3

Professional Barrier

1
2
3

Housing

1
2
3

Financial Resources

1
2
3

Other(s)

1
2
3

If Others, please specify

What groups of individuals would you like to see Freedom do more outreach to? (Rate top 3 most important, 3 being the most important)

Nursing Homes & Assisted Facilities

1
2
3

Mental Health

1
2
3

People with TBI

1
2
3

People with Physical Disabilities

1
2
3

People with Intellectual Disabilities

1
2
3

Elderly

1
2
3

Minority Groups

1
2
3

Children

1
2
3

People with Sensory Disabilities

1
2
3

Other(s)

1
2
3

If Others, please specify

Name*

First Last

Email*

Phone

Name

This field is for validation purposes and should be left unchanged.

Freedom Needs Assessment Questionnaire

What Barriers, if any, do you or the individuals you know or work with, face which make it hard to be independent?

What groups of individuals would you like to see Freedom do more outreach to? (Rate top 3 most important, 3 being the most important)

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