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* By checking this box, I confirm that I am 18 years of age or older.

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* Which of the following do you identify as?

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* What is your primary method of communication?

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* What accommodations do you require?

Thank you for your interest in participating in our research study for improving emergency communications for the d/Deaf, Hard of Hearing, and DeafBlind community. Please leave your contact information on the next page in the marked fields.

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