2024 SFASA Community Survey – Autism Society San Francisco Bay Area

Thank you so much for agreeing to help us update our database! This allows us to keep you informed of:
—all the opportunities available for your family,
—the legislation that directly impacts you and your loved ones, and
—any educational offerings that may benefit you.

This survey should take less than 4 minutes to complete.

The information that you will provide will only be used by SFASA to better communicate with you and to help focus SFASA programs on the emerging needs of our community. We do not sell or rent your information to other parties.

Each family that participates in this survey will receive a $5 credit to an upcoming SFASA event—discount code will be provided upon survey completion. In addition to the credit, each entry will be entered into a raffle for five great prizes:

—1 x $250 Target Gift Card,
—1 x $150 Target Gift Card,
—1 x $100 Target Gift Card,
—1 x $50 Target Gift Card, and
—1 x $25 Target Gift Card.

If you have any questions about this survey, the incentive prizes for completion, or anything else, please do not hesitate to contact Leslie: [email protected] or 408 483 0681.

Your Information

Name *

First

Last

Best email to reach you: *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Your Employer:

Your Spouse's Information

Can you share similar information for your spouse? *

Yes
No
NA

Your Spouse's Name: *

First

Last

Best email for your spouse:

Your Spouse's Phone:

Your Spouse's Employer:

Links to Autism

Can you share the name(s) of your loved one(s) with autism? *

Yes
No
NA / Other

NA/Other

If you don't have a family member or loved one with autism, please take a moment to share your ties to the autism community.

1) Loved one with autism: *

First

Last

1) This person is my:

1) Other:

2) Loved one with autism: *

First

Last

2) This person is my:

2) Other:

Areas of Support

SFASA provides information, education, networking, advocacy, and fun. Please rate your satisfaction with these services on a scale of 1 to 5 (1 being not at all useful and 5 being highly useful).

Events *

Online / Website Resources *

Comments:

Information & Resource Line *

Comments:

Annual Conference *

Targeted Advocacy Efforts *

Comments:

Is there anything else we can do to provide more help to you and your family?

SFASA Events

Have you attended SFASA family events in the past three years?

Yes, and I plan to attend in future.
Yes, but I don't plan to attend in future.
No, but I plan to attend in future.
No, and I don't plan to attend in future.

Why don't you plan to attend in the future?

What are some suggestions for events and activities that you would like us to provide?

How far are you willing to drive to attend one of our events?

30 minutes or less
45 minutes or less
60 minutes or less
Up to 90 minutes

Some of our events have a fee associated with entrance, collateral costs, etc. Are you comfortable covering that fee (usually under $15.00 per person per event) so that SFASA can continue to provide our other services as described above?

Yes
No
It depends on the event

We plan to continue offering a free option for all families who cannot pay to attend. Would you be comfortable donating $1.00 extra per ticket to assist us in covering these costs?

Yes, with each ticket; I understand the growing need.
Yes, not every time, but occasionally.
No.

Annual Conference

Have you attended our SFASA-Stanford conference at Stanford University on adult autism in the past four years? *

Yes, and I plan to attend in future.
Yes, but I don't plan to attend in future.
No, but I plan to attend in future.
No, and I don't plan to attend in future.

Why don't you plan to attend in the future?

Would you prefer to attend in person or virtually?

In person only
Virtually only
Either, it depends

Did you or would you like to use Regional Center Funding to help offset the ticket price of approximately $75?

Yes, no matter what.
Yes, if it didn't involve any lengthy approval process.
No, my loved one does not qualify for regional center services.
No.

What topics would you like to see covered in our annual conference or in any other educational capacity that we could provide?

Closing Thoughts

Is there anything else that you would like to see as additional services for our community?

Please share any other comments or suggestions!

Help Us Declutter!

For many of our long-time, loyal families, we have you listed under multiple different email addresses, phone numbers, and mailing addresses.

Can you provide some additional contact information so we can merge your various contacts into one in our systems? This will help us know who we are serving!

Can you clean up our database by providing some basic contact information?

Yes
No

Old Email #1:

Please provide an old email address, for either you or your partner, that you may have used in past for SFASA events and newsletters, but no longer use.

Old Email #2:

Old Email #3:

Old Email #4:

Old Email #5:

Old Phone Number #1:

Please provide an old phone number, for either you or your partner, that you may have used in past for SFASA events and newsletters, but no longer use.

Old Phone Number #2:

Old Mailing Address:

Address Line 1

Address Line 2

City

State

Zip Code

Your Information

Your Spouse's Information

Links to Autism

Areas of Support

SFASA Events

Annual Conference

Closing Thoughts

Help Us Declutter!

THANK YOU!