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  • The following survey will help us improve services for those who have special needs. Your input is appreciated.

  • What parish do you belong to? Please enter valid data.
  • Who are you filling this survey out for? Yourself Friend Family member
  • Age of person benefitting from this type of Mass: Child Teen/Young Adult Adult Senior Citizen

  • Using a scale of 1 (poor) to 5 (excellent), please rate these areas:

  • Was the environment welcoming None 1 2 3 4 5
  • How was the sensory atmosphere? None 1 2 3 4 5
  • Did the Mass meet your needs? None 1 2 3 4 5
  • Would you like to see this type of Mass offered again? Yes No
  • Other feedback, such as changes, additions, resources that would be of value:
  • Are you or someone you know currently interested in Sacrament preparation? If so, please indicate all that apply. (If yes, please include contact information at the bottom of survey.) Baptism Reconciliation/Confession Communion/Eucharist Confirmation
  • Are there other parish organizations that you would like to be involved in? (If yes, please leave your contact information.) Please enter valid data.

  • Contact Information (Optional)

  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Email Please enter an email address.
  • Phone Number Maximum 20 characters Please enter a phone number.

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