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1. Where do you currently reside?
 
Boulder
 
Longmont,
 
Louisville
 
Superior
 
Lafayette
 
Lyons
 
Nederland
 
Firestone
 
Broomfield
 
Other - please provide
 
 
 
 
2. How familiar are you with the Association for Community Living (ACL) of Boulder County
 
Very familiar – know someone who has used ACL services
 
Somewhat familiar with the name of the organization but really, am not sure of what services it provides
 
Not familiar at all
 
Comment
 
 
 
3. How closely does ACL mission:

“We believe that people with developmental disabilities belong in the community in natural proportions -- to live, to work, and to participate fully in all aspects of community life. The ACL in Boulder County exists to ensure these rights by acting as a catalyst to promote attitudes, practices, programs and policies that result in full participation” align with your personal beliefs?
 
Very strongly
 
Somewhat strongly
 
Neutral
 
Not very strongly
 
Not at all
 
Comment
 
 
 
4. How well do ACL's current programs and the work performed by the organization serve in achieving its mission? Please provide any relevant feedback in the Comments section.
 
Extremely well
 
Quite well
 
Well enough
 
Neutral
 
Not too well
 
Dismally
 
Comment
 
 
5. Please rate your agreement with the following statements (1-lowest, totally disagree, 10-highest, fully agree)

1 2 3 4 5 6 7 8 9 10
Organizations and businesses Boulder/Broomfield communities UNDERSTAND the needs of people with developmental/intellectual disabilities (I/DD)?
Organizations and businesses Boulder/Broomfield communities PROVIDE sufficient support to people with developmental/intellectual disabilities (I/DD)?
 
 
 
6. Do you have a family member/close (local) relative/friend/acquaintance who has a developmental/intellectual disabilities (I/DD)? Are you a person with developmental/intellectual disability yourself?

(If you answer “Yes” to question 6, please answer questions 7 thru 9)
 
Yes, I am a person with developmental/intellectual disability
 
Yes, I have family member/relative/friend who has a developmental/intellectual disability
 
No, none of the above applies to me
 
Comment
 
 
 
7. Do you believe that the person you referred to in question 6 has been the beneficiary of the services provided by the ACL? If you responded "Yes", please use the comment section to provide feedback, on how well the person’s needs were served by the ACL and what needs, if any, were not adequately met.
 
Yes
 
No
 
Comment
 
 
 
8. What organizations (other than ACL) has the person you referred to in question 6 been obtaining support and services from?
 
If none, please check this box and skip this question
 
Please list all that apply in the Comment box below
 
 
9. Please rate the importance of each of the listed types of support services which an organization like the ACL should focus on providing to persons with developmental/intellectual disabilities (I/DD)? Use the scale of 1 (lowest) to 10 (highest)
1 (lowest) 2 3 4 5 6 7 8 9 10 (highest)
Special education advocacy
Adult systems advocacy (Medicaid waivers, health care, employment, public benefits, housing)
Advocacy for family caregivers
Mentorship for isolated self - advocates on the waitlist for services
Group education and support - for families with children
Group education and support- for self-advocates
Group education and support-for family caregivers of adults
Social opportunities at the ACL
Social opportunities in the community
Promoting positive attitudes in the community
Public policy advocacy on behalf of people with I/DD and families
 
 
10. If you are familiar with the ACL of Boulder County, please rate the organization according to the following categories from 1 (lowest) to 10 (highest):
1 (lowest) 2 3 4 5 6 7 8 9 10 (highest)
Relevance of its mission to the needs of the persons with developmental/intellectual disabilities?
Scope of services offered
Quality of services offered
Ease of obtaining the needed services
Quality and commitment of the staff
Overall performance in meeting the needs of its clients
 
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