A Questionnaire for A Proposed Facility Center

for Visually Impaired Individual of Tarlac City

The purpose of this questionnaire is to collect information for the proposed facility for visually
impaired individuals. Your participation in completing the questionnaire is extremely useful. Each part
of the questionnaire has its own instruction. Please strictly follow the instructions of each part before
responding to the questions. Please choose the answer that best reflects your views from the given
alternatives.

Direction: Please answer the following questions. Put a check [✔] mark on the box of your
answer.

1. What services or programs do you believe should be offered at a facility center catering to
visually impaired individuals?

[ ] Skills Training
[ ] Assistive Technology Workshops
[ ] Support Groups
[ ]Healthcare Facilities
[ ]Education
Other (please specify): _______________

2. Are there any specific skills training programs or activities you would like to see offered at
the center?

[ ] Communication Skills
[ ] Mobility Training
[ ] Assistive Technology Workshops
[ ] Arts and Crafts
Other (please specify): ______________

3. In terms of technology, what resources or tools do you believe would be beneficial for
visually impaired individuals at the center?

[ ] Braille Displays
[ ] Screen Readers
[ ] Magnification Devices
[ ] Adaptive Computer Software
Other (please specify): ____________

4. What spaces do you think can be added to aid the facility in being eminent for visually
impaired people? (Select all that apply)

[ ] Multi-Sensory Room
[ ] Braille Library
[ ] Adaptive Technology Lab
[ ] Outdoor Sensory Garden
[ ] Quiet Meditation Space
Other (please specify): ________________
 5. What types of recreational or social activities would you be interested in participating in at
the facility center? (Select all that apply)

[ ] Art and Crafts

[ ] Music and Dance
[ ] Book Club
[ ] Outdoor Excursions
Other (please specify): ____________

6. How important are accessibility features (e.g., ramps, tactile paths) in the physical
infrastructure of the proposed facility center?

[ ] Extremely Important
[ ] Important
[ ] Neutral
[ ] Not Very Important
[ ] Not Important at All

Thank you for taking the time to provide your input on the proposed facility center for visually
impaired individuals. Your responses are valuable in shaping a center that meets the needs and
preferences of the community.