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The Oregon Department of Human Services (DHS) would like to better understand how assistive technology could improve affordable housing services for people with disabilities and seniors. As part of that project, Eugene Research Institute is working with DHS to conduct this survey to find out what people with disabilities, seniors, and those involved in their support know about:

• assistive technology generally,
• the kinds of technology that people are actually using,
• what problems they experience,
• what barriers they can identify that might prevent them from having better access to assistive technology.

We sincerely appreciate your willingness to help us with this project by completing this brief survey. It should take no more than 5-10 minutes of your time.

If you would like this survey in an alternate format (Braille, large type, etc.) or if you know of someone else who would like to complete it but needs an alternate format, please let us know and it will be provided.

You may provide contact info to enable us to provide more information about the survey and its results or about other project activities.

Please be assured that whether you provide follow-up contact information or not, your survey responses will be confidential and anonymous, with no link between your survey and you as an individual.

Thanks very much for your time and consideration.

You can fill out this survey online or on paper:

Download survey on PAPER

(75KB in Microsoft Word format. Viewer available free from Microsoft)

Please print, fill out, and mail to:

Tom Keating, Ph.D.

Project Coordinator

Eugene Research Institute

99 West 10th Avenue, Suite 395

Eugene, OR 97401

Thank you!