Strategy Planning Consumer Feedback

Instructions and $20 Gift Card rules

Please complete the following questions to the best of your ability and provide your contact information so that we may follow-up with a gift card. To receive a gift card, you must be a current Independence Associates consumer. Only one gift card per consumer.

Name

First

Last

Preferred contact method

Email
Phone

like Independent Would

What's your biggest struggle managing your disability?

What do you expect out of an Independent Living Center?

What would improve your independent living community?

What would you like to see Independent Associates offer as a service in the future?

What would improve your access to Independence Associates and the greater independent living community?

Would you like to join our Consumer group that meets quarterly to discuss issues and provide feedback?