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Health Care Access and Equity for Individuals with Disabilities in Maine: ASL Version

Survey for Individuals with Disabilities in Maine

Disability Rights Maine (DRM), with support from the Maine Health Access Foundation, is conducting a research project focusing on the barriers people with disabilities face accessing health care in Maine.  Health care can mean many things. In this survey, when we say the word “health care” we mean hospitals, emergency rooms, dentists, primary care providers, mental or behavioral health providers, and more. If you are not able to receive any health care services, we still want to hear from you. Our goal is to collect data and stories directly from individuals with disabilities across the State of Maine. We know that individuals with disabilities face issues in accessing health care. We also know that many of these problems occur over and over and they are harmful to a person’s health. Unfortunately, data describing these problems does not exist. This is why we want to hear from you.

This survey is a rare opportunity for you to share your experiences. We value you and your experiences. We would appreciate your support in assisting us to make meaningful change to the health care system. The results of this survey will be used by DRM to advocate for policy changes at the state legislature and with other policy-makers to improve access, choice, and quality health care for people with disabilities across Maine.

PLEASE NOTE: If you are assisting someone in completing the survey, please allow the respondent to answer all of the questions themselves. Do not make assumptions or answer a question the way you think they should respond.  At the beginning of each section, you should introduce the next section of questions, (for example, “Now I’m going to ask you some questions about…”). If the respondent is having trouble understanding a question or needs clarification, you may provide explanation or rephrase the question.  You may also rephrase or clarify each response option as needed.  Please fill in any text-box responses as the respondent stated. Do not rephrase or change their response into your own wording.

Instructions for taking the survey
  • This survey will take between 15-30 minutes to complete.
  • All responses are confidential and anonymous, so please respond as open and honestly as you feel comfortable.
There are multiple ways you can complete the survey:
  1. Online, using your phone, computer, or tablet.
  2. With support from family, friend, or with support from DRM staff. If you would like DRM staff to help you complete the survey, please contact Jennifer Battis at or (207) 626-2774.
  3. On a paper copy given to you by DRM staff.
  4. If you would prefer to take the survey in a language other than English, please email or call Jennifer Battis ( or 207-626-2774.

Responding by video in ASL: If you would like to respond to the survey in ASL, please do so! You may record yourself responding to each of the questions and upload the survey to Dropbox by visiting the link here: or emailing the video to  To protect your identity and the confidentiality of your responses, videos will be stored on a protected hard drive, only accessible to DRM staff involved in this project. Your name will not be attached to any video files. Once the project is over, all videos will be deleted.

Survey introduction

Instructions for completing the survey