Physical Location Survey

Profile - Step 1 of 4

We're doing market research to prepare for the launch of our start-up: a community center in Chicagoland where families can go for enrichment activities and programs designed with sensory sensitive children in mind. We'd like to know what kinds of things you would be interested in from a community center like this.

Name

First

Last

Zip Code

# of People in the Family

With Sensory Sensitivities

Without Sensory Sensitivities

Are any of the people in your family with sensory sensitivities the adults?

Yes, one of us
Yes, both of us
Nope, just the kids

How important are the supports listed below are for community center focused on sensory sensitive kids?

Lower Adult/Child ratios

Not important	Slightly important	Very important	Critical
Not importantNot important	Slightly importantSlightly important	Very importantVery important	CriticalCritical

Sensory Accommodations available

Not important	Slightly important	Very important	Critical
Not importantLower Adult/Child ratios Not important	Slightly importantLower Adult/Child ratios Slightly important	Very importantLower Adult/Child ratios Very important	CriticalLower Adult/Child ratios Critical

Environmental sensory inputs are controlled

Not important	Slightly important	Very important	Critical
Not importantLower Adult/Child ratios Not important	Slightly importantLower Adult/Child ratios Slightly important	Very importantLower Adult/Child ratios Very important	CriticalLower Adult/Child ratios Critical

Participating with other children with sensory needs

Not important	Slightly important	Very important	Critical
Not importantLower Adult/Child ratios Not important	Slightly importantLower Adult/Child ratios Slightly important	Very importantLower Adult/Child ratios Very important	CriticalLower Adult/Child ratios Critical

Professional OT trained staff

Not important	Slightly important	Very important	Critical
Not importantLower Adult/Child ratios Not important	Slightly importantLower Adult/Child ratios Slightly important	Very importantLower Adult/Child ratios Very important	CriticalLower Adult/Child ratios Critical

Empathetic staff

Not important	Slightly important	Very important	Critical
Not importantNot important	Slightly importantSlightly important	Very importantVery important	CriticalCritical

What kinds of programs would you hope for at a community center focused on sensory sensitive kids?

Social Experiences

Not Interested	Slightly Interested	Interested	Very Interested
Not InterestedNot Interested	Slightly InterestedSlightly Interested	InterestedInterested	Very InterestedVery Interested

Skill Improvement Experiences

Not Interested	Slightly Interested	Interested	Very Interested
Not InterestedOther Not Interested	Slightly InterestedOther Slightly Interested	InterestedOther Interested	Very InterestedOther Very Interested

Interest based

Not Interested	Slightly Interested	Interested	Very Interested
Not InterestedOther Not Interested	Slightly InterestedOther Slightly Interested	InterestedOther Interested	Very InterestedOther Very Interested

Enrichment

Not Interested	Slightly Interested	Interested	Very Interested
Not InterestedOther Not Interested	Slightly InterestedOther Slightly Interested	InterestedOther Interested	Very InterestedOther Very Interested

Other

Not Interested	Slightly Interested	Interested	Very Interested
Not InterestedNot Interested	Slightly InterestedSlightly Interested	InterestedInterested	Very InterestedVery Interested

What kinds of offerings would you be interested in? (Select all that apply.)

Classes
After school programs
Camps
Party space
Social events
Open play times
Caregiver social events
Caregiver workshops

Would you sign up for the following activities at a sensory-sensitive center?

Creative classes

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Yes, for all of my kid(s)	NoNo

Sports

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Scouts

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Art

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Music

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Dance

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Other

Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)	No
Yes, for my sensory-sensitive kid(s)Creative classes Yes, for my sensory-sensitive kid(s)	Yes, for all of my kid(s)Creative classes Yes, for all of my kid(s)	NoCreative classes No

Would you go to a community center that was focused on sensory sensitive families?

Yes
Maybe
No

What's a good length of time for a social or enrightment experience for your child(ren)?

45 min
1 hour
1.5 hours
2 hours

When would you most likely use this type of community center? (Select all that apply.)

Around naps
After school
When the kids are out of school
Weekends
Random times when we are available

How far are you willing to drive to a community center focused on sensory sensitive kids?

10 min
30 min
1 hour

Are you willing to drive farther than your local community center for one that is built with sensory sensitivies in mind?

Yes
Maybe
No

How much farther are you willing to drive?

10 min
30 min
1 hour

Would you be willing to pay more for an activity that was built with sensory sensitivies in mind?

Yes
Maybe
No

How much more do you think having sensory sensitivities accounted for and supported is worth?

a little bit more (<10%)
this would be worth a premium (<30%)
anything, please just build it! (>50%)
unsure

Do you think that families similar to yours have a similar belief?

Yes
No
Not sure

How did you hear about this survey?

Let us know if you are interested in staying in touch for...

Taking additional surveys
Participating in a focus group
Participating in one-one interviews
Hearing about our progress
Coming to events
You name it, I want to hear about it!

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