• Consumer
• Parent
• Care Giver
• Personal Attendant

Please rate the following items in their number of importance, with 1 being the most important, 2 next most important, so on until you list the least important with the largest number.

1) Employment
I would benefit from:

• Help exploring job and career options
• Job accessibility
• Job readiness training
• Job Placement
• Information about rights of workers with disabilities
• Other:

2) Education
I would benefit from:

• More accessible schools and programs
• Assistance with application and registration (college)
• Computer skills training
• Assistance in obtaining disability benefits
• Independent Living Skills Instruction (money management, communication skills, community resources, cooking skills, personal care)
• Scholarships that help provide for college expenses
• Contact information for Disability Services at local Colleges
• Assistance completing college applications
• Assistance applying for Financial Aid
• Other:

3) Services for Children with Disabilities
My child would benefit from:

• More accessible schools and programs
• Assistance in getting the services needed
• Computer skills training and tutoring
• Sensitivity training for adults who work with children with disabilities
• Parent training and support groups
• Assistance knowing what post-secondary options exist
• An after school program at PILC for high school students
• Other:

4) Housing

• Assistance in finding housing
• Assistance completing application process for HUD
• Assistance understanding the application process for HUD
• Protection from housing discrimination
• More affordable or subsidized housing (HUD)
• Renovations of existing housing
• Other:

5) Assistive Technology
Please check all of the following that apply and then rank their importance with 1 being most important and 10 being least important.

• Mobility Devices
  • Wheelchair
  • Cane
  • Walker
  • Prosthetic device
  • Motorized chair/scooter
• Hearing aides or devices
• Visual Aides or devices
• Speech Aides
• Instruction or training
  • Basic computers
  • Typing
  • Office Applications
  • Hardware
  • Software
• Adaptive computer equipment
  • Voice Recognition software
  • Screen readers (JAWS, MAGIC, ETC)
  • Magnifiers (Zoomtext)
  • Adaptive keyboards
  • Switches
  • Specialized mouse controls
• Other:

6) Communications

• Adaptive equipment to help with communication
• Braille, audio tapes, large print materials for reading and writing
• Sign language interpreters
• Spanish language interpreters
• Other language interpreters
• Other:

7) Transportation
If available, I would use:

• Door to door pick-up
• Accessible fixed route bus service
• Modified independent vehicle
• Transportation Training
• Para-transit system
• Other:

Please rate the following areas concerning your transportation experiences. When I use the following transportation resources, I find the service is:

• Amarillo City Transit:
  • Excellent
  • Good
  • Fair
  • Poor
  • Do Not Use
• Spec Trans
  • Excellent
  • Good
  • Fair
  • Poor
  • Do Not Use
• Jan Werner
  • Excellent
  • Good
  • Fair
  • Poor
  • Do Not Use
• Panhandle Transit
  • Excellent
  • Good
  • Fair
  • Poor
  • Do Not Use
• Local Cab / Bus Companies
  • Excellent
  • Good
  • Fair
  • Poor
  • Do Not Use

What are your biggest barriers to these transportation resources?

• Not accessible to me. Why?
  • Hours of operation
  • Lack training to use effectively
  • My destinations are not on current routes
  • Eligibility or paperwork process difficult
  • The cost of service
  • Other:

8) Health care and Personal Assistance
I need new or better services that provide:

• Doctor or hospital visits
• Prescriptions or medications
• Medical Supplies
• Payment for Personal assistance (attendants)
• Help locating or training attendants
• Other:

What are your biggest barriers to these health care services?

• Exam rooms and equipment are not accessible
• Locating a doctor or clinic that honors my Medicaid or Medicare card
• Lack of transportation to and from the doctor
• Lack of affordable health care
• Lack of affordable dental care
• Lack of affordable vision care
• Lack of affordable mental health care
• Inability to find affordable insurance

Based on the answers you gave; prioritize your need for the following services. Put a (1) on the area with the most need, (2) on the second and end with a (8) on the area with the least need.

• Employment
• Education
• Services for Children with Disabilities
• Housing
• Assistive Technology
• Communications
• Transportation
• Health care and Personal Assistance

What do you think Panhandle Independent Living Center could do to help better serve the community of people with disabilities? Please explain:

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