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Which one of the following categories best describes your relationship to an individual(s) with ASD?

What is your age?

What is your gender?

What is the age of the individual(s) with ASD that you support (select all that apply)?

What is the gender of the individual(s) with ASD that your support (select all that apply)?

What is your marital status?

What is the highest degree or level of school you have completed? If currently enrolled, mark the previous grade or highest degree received.

What is your annual household income?

Do you receive any of the following (check all that apply)?

What is your race/ethnicity?

What county do you live in?

Indicate your degree of agreement with the following statements
 
    Strongly Agree Agree Neutral Disagree Strongly Disagree Not Applicable (N/A)
   
   
   

For the following, please indicate: (a) the degree that you agree with the statement and (b) rate the quality of the services for individuals with ASD provided within the school/community.
Degree of Agreement
Quality of Service Provided in School/Community
 
Strongly AgreeAgreeNeutralDisagreeStrongly DisagreeN/AExcellentGoodSatisfactoryFairPoor
 
 
 
 
 
 
 
 
 
Strongly Agree Agree Neutral Disagree Strongly Disagree N/A Excellent Good Satisfactory Fair Poor
 
 
 
 
 
 
 
 
 
Strongly Agree Agree Neutral Disagree Strongly Disagree N/A Excellent Good Satisfactory Fair Poor