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1. General Information Required

3. State in which the agency is located:

4. How long was the individual with IDD involved with this agency?

9. If you reported the negative experiences, how did the agency or authority respond?(For example: Was the issue acknowledged? Were steps taken to resolve the issue? Please describe.)

10. Were you satisfied with the agency’s response to your report?

☐ Yes☐ No☐ Partially

11. If you were not satisfied or only partially satisfied, what improvements would you like to see in the agency's response?

  12. Involvement with the Tammy Lynn Foundation Would you be interested in becoming involved with the Tammy Lynn Foundation to help advocate for individuals with IDD and their families?(Please select all that apply.)

☐ Yes, as a volunteer

☐ Yes, as an advocate

☐ Yes, by sharing my experiences

☐ Yes, by participating in workshops or focus groups

☐ No, not at this time

Thanks for submitting!

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