Public Comment Survey
Protection & Advocacy, Inc. needs to hear from you!
Protection & Advocacy, Inc. (PAI) is developing its Advocacy Plan. This plan shows the priorities and activities that PAI will work on during the next year.
Look at the 2008-2009 Priorities,
Goals and Objectives that we are proposing by clicking here
. Answer the questions below and tell us if you agree that these issues are important to you or if there are other priorities or activities you want PAI to consider for this next year. If you need help, please call us at (800) 776-5746 and say, "I need help with your survey."
1. This is a list of disability rights issues. Check the issues that you want to tell us about.
Abuse and Neglect
Discrimination
Benefits
Education for Children and Youth
Lanterman Act
Mental Health
Peer and Self-Advocacy Services
Collaborative Projects
All these issues
Tell us why the issue you checked is important to you.
Do you have any other suggestions for us?
2. ABOUT YOU. (Optional) We should appreciate knowing more about you. Check all that apply.
What is your ethnicity?
African-American
Asian/Pacific Islander
Caucasian
Hispanic/Latino
Native-American
Identify with more than one ethinic group
Other
Are you a person with a disability?
Developmental Disability
Learning
Physical
Psychiatric
Sensory
Traumatic Brain Injury
Are you a family member of a person with a disability?
Developmental
Learning
Physical
Psychiatric
Sensory
Traumatic Brain Injury
ARE YOU?
Living in a Facility
Advocates for people with disabilities
Service provider
Other
Thank you for taking the time to complete this survey. Click the SUBMIT button and your survey will automatically be received. If you have any questions or would like further information regarding this survey or the planning process, please contact Barbara Silva, Protection & Advocacy, Inc., 3580 Wilshire Blvd., Suite 902, Los Angeles, CA 90010, Tel: (800) 776-5746 or at Barbara.Silva@pai-ca.org. If you would like a copy of our Advocacy Plan, please check the box below.
I would like a copy of PAI's Advocacy Plan.
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Last Name
Street Address
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