Open Hearts, Open Minds, Open Doors Program
How can I make my faith community more inclusive: Accessibility Survey
ACCESSIBILITY
SURVEY
Statistics show that one out of five Americans has a
disability. We would like to learn more about the needs of our
congregation and the barriers that may prevent full participation at our
house of worship. Please take a few minutes to complete the following
survey. Thank you.
1.
The person who could participate more fully if
accommodations were provided is (Check all that apply):
|
q
Self |
q
Family Member
|
q
Acquaintance |
q
Don’t know anyone
(Please continue) |
2. What would allow full participation in worship at our
house of faith?
q
Invitation to participate
q
Disability awareness training for staff and congregation
q
Drop off area
q
Accessible parking spaces
q
Curb cuts
q
Ramps
q
Automatic doors
q
Doors 36 inches in width
q
Greeters who could assist
q Clearly marked
accessible bathrooms
q
Accessible pulpit/bimah
q
Assistive listening devices for persons with hearing needs
q
Sign language interpreter
q
Braille materials
q
Large print liturgy guides/hymnals
q
Pew cuts or accessible spaces throughout the worship space
q
Pew without kneelers
q
Padded seating with arm rests
q
Pews 32 inches apart to allow for use of walkers,
canes, crutches
q
Other _________________________________________________
3. What
other area(s) limit or prevent full participation?
|
q
Meeting rooms |
q
Lighting |
q
Carpet/floor coverings |
q
Sound system |
|
|
q
Gym |
q
School building |
q
Social Hall |
q
Office/rectory |
|
q
Sanctuary |
q
Attitudes |
q
Other(s): ______________________ |
4. Please check ministries in our faith community that are
not accessible:
|
q
Altar server
|
q
Choir member
|
q
Lector |
q
Usher |
q Greeter |
|
2. qReligious
education teacher |
q
Religious education
student |
q
Day school student |
q
Liturgical minister
|
|
q
Leadership council
|
q
Teen group |
q
Women’s guild |
qOther:_______ |
Additional
Comments:__________________________________________________________________
___________________________________________________________________________________
Name:______________________________________________________
Address:____________________________________________________
City:
State: Zip Code:
Phone:
q
Yes, I would like to serve on an inclusion committee
to help make our faith community more accessible and welcoming. I have
completed the above information so that you may contact me.
|
