Fall 2022 Self-Advocacy Satisfaction Survey

Race/Ethnicity *

White, alone

Black or African American, alone

American Indian or Alska native, alone

Hispanic/Latino

Asian, aone

Native Hawaiian or other Pacific Islander, alone

Two or more races

Race unkown Race unkown

Gender *

Femal

Male

Other

Geographic Area *

Urban

Rural

What region of the state of Minnesota are you from *

Are you satisfied with this project activity? *

yes

no

I am an individual with a developmental disability *

yes

no

Have you gone through a DETS course and completed an end of class survey in the past year? *

yes

no

Please answer the following questions with a Yes or No. Because of this Self-Advocacy activity: *

	Yes	No
I am increasing my advocacy	Yes	No
I am better able to say what I want, and what is important to me	Yes	No
I am now participating in advocacy activites	Yes	No
I am serving on a cross-disability coalition, policy board, advisory board, governing body and or serving in a leadership position	Yes	No

If you are serving on any coalitions, political groups, advocacy groups, planning committees or any disability rights related groups, please name them. *

Please help us to know your how your levels of independence, productivity, self-determination, integration and inclusion (IPSII*) have increased as a result of participating in this Self Advocacy training session. Evaluate yourself on a scale of 1 ( lowest) to 5 ( highest) for each measure. *

	5 - Has increased very much	4	3	2	1 - Has not increased at all
Independence: Since participating in this Self Advocacy training session, I have become more independent* at work, home or school.	5 - Has increased very much	4	3	2	1 - Has not increased at all
Productivity: Since participating in this Self Advocacy training session, I am more productive.*	5 - Has increased very much	4	3	2	1 - Has not increased at all
Self Determination: Since participating in this Self Advocacy training session, my self-determination* has increased.	5 - Has increased very much	4	3	2	1 - Has not increased at all
Integration and Inclusion: Since participating in this Self Advocacy training session, I have experienced more community integration and inclusion.*	5 - Has increased very much	4	3	2	1 - Has not increased at all

*Independence means the extent to which individuals exert control and choice over their own lives.

*Productivity means starting employment or a positive change in one's employment situation (better wages, hours, benefits, improved status, or job advancement).

*Self-determination means the freedom to choose where and with whom to live or taking personal responsibility for personal decisions about needed supports and services

*Integration and inclusion means using the same community resources that are available to other citizens or fully participating in community activities.

For the questions below please rate on a scale from 1-5 how strongly you agree (5) or disagree (1) with the statements. *

	5 - Strongly Agree	4 - Agree	3 - Niether Agree nor Disagree	2 - Disagree	1 - Strongly Disagree
As a result of hearing this presentation, I gained new knowledge about the subject or topic area.	5 - Strongly Agree	4 - Agree	3 - Niether Agree nor Disagree	2 - Disagree	1 - Strongly Disagree
The information presented will be useful to me in the future	5 - Strongly Agree	4 - Agree	3 - Niether Agree nor Disagree	2 - Disagree	1 - Strongly Disagree
The presenter was knowledgable about th topic area and was effective in presenting the material	5 - Strongly Agree	4 - Agree	3 - Niether Agree nor Disagree	2 - Disagree	1 - Strongly Disagree

Were there any features or functionalities that you felt were missing or should be added?

Comments or Suggestions