Voter Experience Survey

Your County: Please Select ADAIR ALLEN ANDERSON BALLARD BARREN BATH BELL BOONE BOURBON BOYD BOYLE BRACKEN BREATHITT BRECKINRIDGE BULLITT BUTLER CALDWELL CALLOWAY CAMPBELL CARLISLE CARROLL CARTER CASEY CHRISTIAN CLARK CLAY CLINTON CRITTENDEN CUMBERLAND DAVIESS EDMONSON ELLIOTT ESTILL FAYETTE FLEMING FLOYD FRANKLIN FULTON GALLATIN GARRARD GRANT GRAVES GREEN GREENUP HANCOCK HARDIN HARLAN HARRISON HART HENDERSON HENRY HICKMAN HOPKINS JACKSON JEFFERSON JESSAMINE JOHNSON KENTON KNOTT KNOX LARUE LAUREL LAWRENCE LEE LESLIE LETCHER LEWIS LINCOLN LIVINGSTON LOGAN LYON MADISON MAGOFFIN MARION MARSHALL MARTIN MASON MCCRACKEN MCCREARY MCLEAN MEADE MENIFEE MERCER METCALFE MONROE MONTGOMERY MORGAN MUHLENBERG NELSON NICHOLAS OHIO OLDHAM OWEN OWSLEY PENDLETON PERRY PIKE POWELL PULASKI ROBERTSON ROCKCASTLE ROWAN RUSSELL SCOTT SHELBY SIMPSON SPENCER TAYLOR TODD TRIGG TRIMBLE UNION WARREN WASHINGTON WAYNE WEBSTER WHITLEY WOLFE WOODFORD

Your Polling Place

The entrance to your polling place has Please Select Gravel Pavement Wood Steps

If steps, was there a ramp available?
Yes
No

Yes
No

If yes, what type of assistance is needed?

Did you request assistance?

If yes, did you receive assistance?

Who gave assistance?

Poll worker
Person who came with me
Other

If Other, please specify

Were you able to cast your vote privately?

Yes
No

Were you questioned by anyone about your choice?

Yes
No

If yes, who questioned you?

Was your voting experience a good one?

Yes
No

In your opinion, is there anything that would make the voting process easier at your polling place?

Yes
No

If yes, what would that be? (specify)

Other comments on your voting experience:

If you would like to discuss your experience further with a Protection and Advocacy advocate, please write your name and phone number below:

Your Name:

Your Email Address: