Autism Friendly Community


WE VALUE YOUR INPUT!

Help us continue to build an autism friendly community by completing the following survey regarding your recent experience at an Autism Friendly Business.
Please tell us about yourself and your visit:
Business You Visited(*)
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Date of Visit(*)
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Are you ...(*)

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Age of Person with ASD(*)
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Did you find the employees to be knowledgeable in autism awareness?
(*)
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Comments
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Were your needs met during your visit?
(*)
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Comments
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Is there anything the staff/organization could have done to improve your experience?
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Comments
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How likely are you to visit or recommend this business to a friend?
(*)
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If you would like to be contacted regarding your feedback, please complete the fields below.
Your Name
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Your Phone Number
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Your Email
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THANK YOU FOR YOUR FEEDBACK!

We take all feedback seriously and will pass along these comments to all parties involved. If you requested to be contacted, we will contact you within 1 business day.