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Greene County, Georgia Public Accessibility Survey Greene County Government Facilities Date completed: , 20 Optional Information (Name, Address, Telephone, e-mail) Facility or Service being commented about: Please answer the following questions. You may indicate you response as follows: Y – Yes N – No DK – Don’t Know NA – Not Applicable or write your response in the Comments box. We also encourage you to provide any additional comments to clarify your answer to these questions. Question Y N DK NA Comments 1. Are you a Community Member/ Employee/ Visitor/ Contractor/Participant of a program, Service, or Activity? 2. Programs or activities in which you participate (please note all that apply) – Meetings/ Classes/ Work (Volunteer)/Work(Employee)/ Recreation/ Sporting Events/ Other (describe) 3. Have you ever requested an accommodation for a disability from the County? If an accommodation was requested, was your accommodation made by the County? 4. Have you experienced any exterior barriers, non-accessible areas, or non-accessible programs no accessible parking spaces, difficulty reaching an accessible entrance, steep ramps, uneven sidewalks, etc.)? ---PAGE BREAK--- Question Y N DK NA Comments 5. Have you experienced any interior barriers, non-accessible areas, or non-accessible programs inside a Greene County facility? stairs only to the facility, narrow doorways, protruding objects in the hallways, lack of assistive devices, missing or inappropriate signage, lack of interpreters, etc.) 6. Is accessible seating provided for individuals with disabilities at programs, community events, etc. held at Greene County facilities? 7. Are you aware of any programs, services, or activities that are not accessible to individuals with disabilities? 8. Are you aware of any areas and elements of any Greene County facility that are not accessible to individuals with disabilities? 9. Is information provided regarding accommodations, auxiliary aids (such as assistive listening systems, interpreters), alternate formats, specialized equipment, or assisted services, etc.? 10. Is there adequate directional and informational signage provided at County facilities? 11. If you have requested auxiliary aids, an interpreter, or specialized equipment, was your request accommodated? 12. Do you know who to contact to request accommodations for yourself, a relative, or a friend with a disability? 13. Is the attitude of Greene County (or its employees) towards you, or someone you know with a disability, generally helpful, supportive, positive, and proactive in solving accessibility issues? Mail completed survey to: Greene County Board of Commissioners ADA Coordinator 1034 Silver Drive, Suite 201 Greensboro, GA 30642