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EPRC Needs Assessment V.3

Helping Us Help You!

Thank you for taking this short survey.  Our mission is to provide useful referral, support, social, advocacy, training and educational services to parents, caregivers and youth with disabilities.  

If you wish to be contacted, please select YES at the end of the survey and provide your contact information.

Please answer all questions and help guide us.
2. In which county do you reside? 
4. Are you a (check all that apply): 
6. Please select all needs that are current concerns.
7. If you are interested in information for one or more specific disabilities, please list the disabilities here.
9.  For Youth or Young Adult (age 13-26) with Disabilities:  If you are a person with a disability age 13-26, please select any areas that you would like information and support on.
10. Do you want to be contacted by a Resource Specialist from the EPRC?
11. If you answered YES to question 10, please enter your contact information.