A survey instrument is presented that is designed to explore the in-service training needs of general elementary and secondary teachers as they relate to learners with physical disabilities. It contains 75 items and takes 20-25 minutes to complete. The survey includes questions about the educator's teaching experience, teacher training in special education, attitudes and knowledge level of children with physical disabilities, particularly of those with Duchenne dystrophy, cerebral palsy, and spina bifida, educational needs of students with physical disabilities, knowledge level of adaptive equipment, environmental adaptations, and self-confidence in knowledge level. Most items on the survey ask the participant to rate a statement on a 5-point scale, with 5 meaning the participant strongly agrees with the presented statement and 1 meaning the participant strongly disagrees with the statement. (CR)