Take the Survey - Digital Access Project

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Take the Survey and Let's Get Started!

Thank you for taking the Digital Access Project Survey.
Complete the four question survey below to find out what low-cost Internet options are available to you.

Leave this field empty:

Question #1:

Do you already have high-speed Internet access in your home?

Yes, I do. No, not at this time.

Question #2:

Is the bill in your name?

Yes, it is. No, it's not.

Question #2:

Where do you have access to the Internet?

School Work Family/Friend's House Cell Phone Other

Please describe other location:

Question #3:

Does anyone in your household have a learning, walking, speaking, vision, hearing or mental health challenge?

Yes. No.

Question #4:

Please complete your personal information below:

Full Name: Email Address: Phone Number: Zip Code:

Who referred you to the Digital Access Project?

SCE SMUD Ability Tools Toll-Free Number Molina Healthcare Inland Empire Health Plan SoCal Gas Other Please enter name of referral:

Are you a Lifeline customer?

Yes, I'm a Lifeline customer. No, I am not. I am not sure.

What is your preferred language?

(800) 390-2699 • (800) 900-0706 TTY

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A Project of the California Foundation for Independent Living Centers,
in part funded by the California Emerging Technology Fund.