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Needs and Smart Home Survey

This 5-7min form is for assessing focus of need, basic technical abilities, and current smart home setup for assistive technology. This will help us have the most productive call possible.

What area(s) do you need support for?
What is the primary barrier(s) you are looking to address?
Do you currently use any smart home devices (e.g., smart speaker, smart lights, smart thermostat)?
Yes
No
Not Sure
If you use smart home devices, please indicate which types (Select all that apply).
On a scale of 1 to 5, how comfortable are you or the person in your care generally using a smartphone or tablet for daily tasks?
1: Not comfortable at all
2: Have a little time using one
3: Feel OK about using them
4: Spent plenty of time using them
5: Very comfortable

Please rate your experience with the following technical concepts/tasks:

How frequently do you use voice commands (e.g., "Hey Google", "Alexa") to control devices or get information?
Multiple times a day
Once a day
A few times a week
Rarely
Never
Do you have reliable Wi-Fi coverage throughout your home?
Yes, coverage is excellent everywhere
Mostly, with a few weak spots
No, coverage is generally poor or unreliable

If within the home and connected to WIFI, click the link below to test your internet speed and note it below. (link takes you to Google, click "Run Speed Test") https://bit.ly/4plUw1E

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