Living Life Your Way Survey
disAbility Resource Center Independent Living Video Series
Name or Topic of Video
*
Your Email
What is your zip code?
How did you hear about this video?
Website
Facebook
Twitter
Instagram
YouTube
Staff member
Other
Please evaluate honestly
*
Excellent
Very Good
Good
Fair
Poor
N/A
The video content was:
Video's length was:
Illustrations used were:
Captions were:
The audio was:
The quality of the presenter
(engaging, knowledgeable)
was:
The quality of the video was:
I learned something new:
Yes
No
I will personally use the information from the video?
Yes
No
I will share this information with others?
Yes)
No
What are other information would you like to learn about from the dRC :
Housing
Transportation
Employment
The American with Disabilities Act
Independent Living Skills (cooking, budgeting, home upkeep, etc.)
Recreation and Social Opportunities
Health and Nutrition
Social Security
Medicaid Waivers
Other
Additional Comments:
Evaluate Now!
Should be Empty: