VoiceAbility Survey
Purpose: To gather information to help develop and tailor the VoiceAbility training program - a self-advocacy capability building program for people with disabilities.
1. Name
First Name
Last Name
2. Email
example@example.com
3. Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
4. Preferred Way to Contact You
Email
Phone
5. Age Group
Under 18
18-24
25-34
45-54
55-64
65 and over
6. Do you identify as having a disability?
Yes
No
7. Which group do you belong to? (Tick all that apply)
CALD (Culturally and Linguistically Diverse) background
At risk of homelessness
Facing long-term employment barriers
Coming out of the criminal justice system
Other
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Section 2: Current Knowledge and Advocacy Skills
In this section, we are trying to understand your current knowledge or your rights and barriers.
1. Workplace Rights:
How sure are you that you know your rights at work?
Not sure at all
A little sure
Very sure
Completely sure
Do you know how to ask for changes or help at work?
Yes
No
How comfortable are you talking to a manager or boss?
Not comfortable at all
A little comfortable
Somewhat comfortable
Very comfortable
Completely comfortable
Have you ever felt unfairly treated at work because of your background, where you live, your job history, or any past legal issues? (You might have experienced unfair treatment for one or more of these reasons).
Yes
No
Do you know where to get help if you have problems at work?
Yes
No
How confident are you in finding a job that suits your needs?
Not confident at all
A little confident
Somewhat confident
Very confident
Completely confident
2. Housing Rights:
How sure are you that you know your housing rights?
Not sure at all
A little sure
Very sure
Completely sure
Do you know how to find and apply for housing?
Yes
No
How comfortable are you talking to landlords or housing officers?
Not comfortable at all
A little comfortable
Somewhat comfortable
Very comfortable
Completely comfortable
Have you ever felt treated unfairly when looking for housing because of your background, where you live, your job history, or any past legal issues? (You might have experienced unfair treatment for one or more of these reasons).
Yes
No
Do you know where to get help if you have housing problems?
Yes
No
How confident are you in finding a place to live that meets your needs?
Not confident at all
A little confident
Somewhat confident
Veryconfident
Completely confident
3. Health Rights:
How sure are you that you know your health rights?
Not sure at all
A little sure
Very sure
Completely sure
Do you know how to find and use health services?
Yes
No
How comfortable are you talking to doctors or health workers?
Not comfortable at all
A little comfortable
Somewhat comfortable
Very comfortable
Completely comfortable
Have you ever felt treated unfairly when getting health care because of your cultural background?
Yes
No
Do you know where to get help if you have health problems?
Yes
No
How confident are you in managing your health and well-being?
Not confident at all
A little confident
Somewhat confident
Very confident
Completely confident
4. Education Rights:
How sure are you that you know your education rights?
Not sure at all
A little sure
Very sure
Completely sure
Do you know how to find and use education services?
Yes
No
How comfortable are you talking to teachers or school staff?
Not comfortable at all
A little comfortable
Somewhat comfortable
Very comfortable
Completely comfortable
Have you ever felt treated unfairly at school or in training because of your background, where you live, your job history, or any past legal issues? (You might have experienced unfair treatment for one or more of these reasons).
Yes
No
Do you know where to get help if you have education problems?
Yes
No
How confident are you in managing your education and learning?
Not confident at all
A little confident
Somewhat confident
Very confident
Completely confident
5. General Self-Advocacy
How confident are you in speaking up for your rights in general?
Not confident at all
A little confident
Somewhat confident
Very confident
Completely confident
Do you feel you have the skills to speak up for yourself?
Yes
No
How comfortable are you asking for help from advocacy services?
Not comfortable at all
A little comfortable
Somewhat comfortable
Very comfortable
Completely comfortable
Have you ever taken part in any advocacy training or workshops?
Yes
No
How confident are you in helping others to speak up for their rights?
Not confident at all
A little confident
Somewhat confident
Very confident
Completely confident
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Section 3: Training Needs and Preferences
1. What topics would you like to learn more about? (Tick all that apply)
Workplace Rights
Housing Rights
Health Rights
Education Rights
Self-Advocacy Skills
Other
2. What type of training do you prefer? (Tick all that apply)
In-person workshops
Online webinars
Printed materials
One-on-one coaching
Group discussions
Other
3. What days and times are best for you to attend training? (Tick all that apply)
Weekdays (morning)
Weekdays (afternoon)
Weekdays (evening)
Weekends (morning)
Weekends (afternoon)
Weekends (evening)
4. Do you need any specific help or accommodations to take part in the training?
No
Other
5. Is there anything else you would like to share about your training needs or preferences?
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Section 4: Methodology and Approach
1. How do you prefer to learn new information?(Tick all that apply)
Seeing (visual)
Hearing (auditory)
Doing (kinesthetic)
Reading/Writing
2. What teaching methods do you find most effective? (Tick all that apply)
Lectures
Interactive activities
Group discussions
Case studies
Role-playing
Other
3. What considerations should we keep in mind to make the training more effective for you?
Submit
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