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Disability Inclusion Questionnaire

DISABILITY INCLUSION QUESTIONNAIRE

Please fill this out to both request specific accommodations and/or provide feedback on our current inclusion practices.

    Diversity and inclusion are core Jewish values. The Disability Inclusion Committee is trying to identify barriers to full accessibility at Agudas Achim, whether they are physical, architectural, sensory, social, intellectual, or educational.  This survey seeks to capture the experiences of all of our members regarding their abilities to access our programs, building, and communal life.  We recognize that some congregants do not identify as having disabilities, but nevertheless, have health-related limitations that keep them from participating in some or all aspects of congregational life.

    The questions in this survey will help you explain your and/or your family members’ needs so we can best address them. Please be assured that individual responses will be kept confidential. Names and contact information are optional.  However, if follow-up discussion with you will help us better understand you and/or your family members’ situation, we will need your contact information.

    Your answers to the survey questions will help the Agudas Achim Disability Inclusion Committee to identify and recommend needed changes to policies, practices and procedures which will ensure greater access for individuals with disabilities, address the specific accommodation needs of individual congregants, and assist in identifying and prioritizing physical changes which may require the expenditure of resources. 

Your answers will be kept confidential, however, we ask for your name and contact information in case we have questions.
If your answer is "No," please explain below.