ASD-CARC :: Take a survey

*	Person completing this form:
*	Email address:
*	Telephone number:
*	Your current city/town:
*	Birth date of student with ASD:
Diagnosis of individual with ASD:
	Autism verbal
	Autism non verbal
	Asperger Syndrome
	PDD NOS
	Other
*	Where is the student with ASD going after leaving school?
*	Do you have a transition plan for the ASD student leaving school?	Yes No
Please click on a tab to answer questions on a page. When you are finished answering all the questions, please click on finish to submit your responses. We thank you for your participation. Please click here to find out more about participating in ASDCARC's research.

What are your child's current services? Please select from the following list:
*	Education
*	Clinical assessments
*	Case Management Service
*	Behaviour support/management
*	Speech and Language Services
*	Occupational Therapy Services
*	Respite - In Home
*	Respite - Out of Home
*	Special Services At Home Funding
*	Residential Supports
*	Employment Services
*	Life/ social/ recreation skills development
	Community Care Access Centre support (please specify)
*	Community Care Access Care support
	Psychology / Psychiatry (please specify)
*	Psychology / Psychiatry
*	Social Group
*	Individual Support group
*	Parent / Family Support Groups
*	Individual & Family therapy/ counseling
*	Assistance in long term planning
*	Autism Spectrum Disorder Resource Source
	Other
	Other - Please specify
	Other
	Other - Please specify
Please click on a tab to answer questions on a page. When you are finished answering all the questions, please click on finish to submit your responses. We thank you for your participation. Please click here to find out more about participating in ASDCARC's research.

What services do you know are available after graduation? Please select from the following list:
*	Education
*	Clinical assessments
*	Case Management Service
*	Behaviour support/management
*	Speech and Language Services
*	Occupational Therapy Services
*	Respite - In Home
*	Respite - Out of Home
*	Special Services At Home Funding
*	Residential Supports
*	Employment Services
*	Life/ social/ recreation skills development
	Community Care Access Care support (please specify)
*	Community Care Access Care support
	Psychology / Psychiatry (please specify)
*	Psychology / Psychiatry
*	Social Group
*	Individual Support group
*	Parent / Family Support Groups
*	Individual & Family therapy/ counseling
*	Assistance in long term planning
*	Autism Spectrum Disorder Resource Source
	Other
	Other - Please specify
	Other
	Other - Please specify
Please click on a tab to answer questions on a page. When you are finished answering all the questions, please click on finish to submit your responses. We thank you for your participation. Please click here to find out more about participating in ASDCARC's research.

	Please provide us with feedback, including how we might help you further.
*	I give my consent to share my personal information with ASO:
*	Would you like a copy of the survey results?	Yes No
If so, please ensure you provided your e-mail address on the first page.
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Please click on a tab to answer questions on a page. When you are finished answering all the questions, please click on finish to submit your responses. We thank you for your participation. Please click here to find out more about participating in ASDCARC's research.