Survey in Response to Coronavirus (COVID-19)

This survey is to gain further insight for the response during the coronavirus COVID-19 outbreak for people with disabilities. If you are a family member, please fill out this information about the person with a disability, not yourself.

Survey for individuals with disabilities & their family members in response to the coronavirus COVID-19 outbreak

This survey is to gain further insight for the response during the coronavirus COVID-19 outbreak for people with disabilities. If you are a family member, please fill out this information about the person with a disability, not yourself.


Who is filling out this survey?

What is you/your family member's disability? (Check all that apply.)

Are you/your family member a student with an IEP?
Have you continued to receive educational services since your school closed?

Are you a client of one of California’s Regional Centers?
If you answered yes, what is the name of your Regional Center?
Have you asked for additional regional center services or support to help you because of the Coronavirus outbreak?
Have you received the additional services you requested?
How do you feel about the Regional Center’s response to COVID-19.

Who do you/your family member live with?

If you have direct support workers, are they still coming to your home?
If yes, have they reduced their hours?

Have you experienced any discrimination since the coronavirus outbreak because of your disability?

Do you live in a facility, recently left a facility, or have a loved one in a facility?

Have you been able to access food, groceries, and other household supplies?

Do you know how to get the federal stimulus check?

Do you know where to find information about COVID-19?

Is the information in your language?

Do you understand the information that you are getting from all of your service providers?