Join the VIP

About Me *

Choose all that apply (must select at least one)

I have a disability

I am a family member who supports a person with a disability

I am a legal guardian who supports a person with a disability

I identify with the following disabilities (for myself or my family member) *

Choose all that apply (must select at least one)

Autism spectrum

Blindness/low vision

Brain injury

Chemical dependency

Chronic health condition

Deaf or hard of hearing

Development disability

Intellectual disability

Learning disability

Mental health

Physical or mobile disability

Speech or language disability

Temporary disability

I identify with the following race/ethnicities *

Choose all that apply (must select at least one)

Non-Hispanic White, European or Euro-American

Black, Afro-Caribbean, African or African-American

Hispanic, Chicano or Latino

Asian and Pacific Islander

Middle Eastern or Arab-American

Native American, American Indian or Alaskan Native

Programs/services/tools I have used or am using *

Choose all that apply (must select at least one)

Consumer Support Grant

Disability Hub MN (formerly Disability Linkage Line)

DB101.org (Disability Benefits 101)

Family Support Grant

HB101.org (Housing Benefits 101)

HCBS Waiver (DDD, CAC, CADI, BI)

Home Care (PCA, Home Health Aide, Home Care Nursing)

Minnesota Aging Pathways

MinnesotaHelp.info

Program HH/ADAP (AIDS Drug Assistance Program)

State Services for the Blind (SSB)

Vocational Rehabilitation Services (VRS)

Types of activities that you want to participate in *

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Focus groups in person

Focus groups with online presentation

Focus group phone conferences

Interview phone conferences

Interviews in person

Interviews with online presentation

Technology *

Choose all that apply (must select at least one)

Computer/tablet in home with internet/email

Computer/tablet in home but not internet

Internet/email in a public space

Smart phone with internet/email

Smart phone without internet/email

someonereferredme *

Yes

No