By completing this survey, you will help improve services for deaf people in business. This is sponsored by Deaf and Hard of Hearing Entrepreneurs Council. Please fill out this survey to the best of your knowledge and click on the submit button after you are done. Thank you for participating in this survey.
Deaf Business Survey
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1. Gender
Male
Female
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2. Age
under 10
11 - 20
21 - 30
31 - 40
41 - 50
51 - 60
61 - 70
71 - 80
81 - 90
over 90
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3. Ethnic Origin
African American
Asian
Caucasian
Hispanic
Native American
Other
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4. Education
High School
Vocational Degree
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Post-Doctoral Studies
Professional Certification
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5. Employment Status
Full Time
Part Time
Self Employed
Student
Homemaker
Retired
Disabled
Unemployed
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6. Degree of Hearing Loss
Normal
Minimal (16 to 25 dB HL)
Mild (26 to 40 dB HL)
Moderate (41 to 55 dB HL)
Moderate-to-Severe (56 to 70 dB HL)
Severe (71 to 90 dB HL)
Profound (91 dB or greater HL)
Don't Know/Not Sure
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7. Do you rely on sign language or visual cues to communicate?
(Please choose your primary form of communication)
None
American Sign Language (ASL)
Pidgin Signed English (PSE)
Signed English (SE)
Cued Speech
Lipreading
Other
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8. Do you rely on an Assistive Listening Device(ALD)?
(Please choose your primary ALD)
None
Hearing Aids
Cochlear Implants
FM System
Other
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9. State of Primary Residence
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
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10. Are you a business owner?
Yes
No-- Skip to Question 13
11. If yes, what type of business?
Home-Based Business
Professional Services
Small Business (Less than $5 Million Annual Revenue)
Large Business
12. How much ownership do you have in your business?
More than 51%
25% to 50%
Less than 25%
13. If you answered no to question 10, do you plan to start a business in the future?
10 or more years
7 to 9 years
4 to 6 years
1 to 3 years
Less than 1 year
No
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14. Have you ever used services offered by the Small Business Administration?
Yes
No
15. If your answer to question 14 is no, why not?
Lack of communication access/sensitivity to needs
Did not feel comfortable
Did not know about their services/where to get services
Did not need their services
Other
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16. If there is a Deaf Business Center that provides workshops, training programs, professional services, and financial counseling at a low cost to deaf people in your area, would you use their services?
Yes
No
17. Email Address (This will not be revealed outside of this new organization - we respect the standard privacy policy.)
Receive Mass Email?
I would like to receive email updates about developments in deaf business.
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