Helping Families One Hand At A Time | info@ohanacenterav.org

EARTH Program Questionnaire

FOR AGES 12+

Thank you for taking the time to complete this voluntary survey. Your responses are valuable in making decisions about the programming we provide. Please complete the questions below and on the back of this survey. Please select the response which best represents your opinion. There are no right or wrong answers. All responses are anonymous and will give you access to the EARTH Program content for free.

If you prefer not to answer any of the questions, please select "Decline to answer."
If you prefer not to answer any of the questions, please select "Decline to answer."
If you prefer not to answer any of the questions, please select "Decline to answer."
If you prefer not to answer any of the questions, please select "Decline to answer."
* For this questionnaire, disability is defined as mental or physical impairment lasting more than 6 months and limiting major life activity but is not the result of a severe mental illness. (If you prefer not to answer any of the questions, please select "Decline to answer.")
If you prefer not to answer any of the questions, please select "Decline to answer."
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