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PROVIDER AGENCY SURVEY
We need your feedback! The Developmental Disabilities Administration (DDA) and the Governor's Office of the Deaf and Hard of Hearing want to support your provider agency as you serve people with developmental disabilities who are deaf and hard of hearing.
By completing this survey, you will help us identify areas of opportunity to provide you with the most appropriate supports and resources. Thank you!
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* Indicates required question
What is the name of your provider agency?
*
Your answer
Which region(s) are you in?
*
CMRO
SMRO
ESRO
WMRO
Required
How many Deaf, hard of hearing, and DeafBlind individuals do you serve?
*
Your answer
How many employees in your agency identify themselves as Deaf, hard of hearing, or DeafBlind?
*
Your answer
How many Deaf, hard of hearing, and DeafBlind employees as identified above are in supervisory or management roles, supervising employees?
Your answer
What type of specialty or training have your employees received for working with Deaf, hard of hearing, and DeafBlind individuals with developmental disabilities?
*
Your answer
Please check any of the following services your provider agency is familiar with:
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Registry of Interpreters for the Deaf (RID) - Certified Interpreter
Registry of Interpreters for the Deaf (RID) - Certified Deaf Interpreter
Pro Tactile Interpreter
Video Remote Interpreter (VRI)
Support Service Providers (SSP)
Onsite Communication Access Real-Time Translation (CART)
Remote Communication Access Real-Time Translation (CART)
Assistive Listening System
None of the above
Required
Do you have a protocol in place for interpreting services?
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Yes
No
Not sure
How can the Governor's Office of Deaf and Hard Hearing and the DDA better support your agency in serving Deaf, hard of hearing, and DeafBlind individuals with developmental disabilities?
*
Your answer
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