Thank you for your interest in participating in the “Count Us In” survey being conducted by DEEN Support Services, a registered Canadian charity. This questionnaire has been developed to gather information on the current demographics of persons with disabilities specifically in the Muslim community so we can understand how to better support and serve our community members with disabilities and their families. We are also wanting to understand your overall experiences in accessing services.

Please complete this survey if you identify as Muslim and have a disability, or you are a family member and caregiver of a Muslim individual with a disability who cannot independently complete this survey. We value your honest and detailed responses. The questionnaire should take approximately 15 minutes to complete.

Your responses are completely anonymous. Your postal code is required to assist us with geographic mapping of needs and not to identify you as the survey respondent.

Should you wish to enter a draft to receive a gift card for $50, please complete your contact information.

Also, please indicate if you wish to remain connected to our organization.

For more information on this research project, please feel free to contact: or call (905) 593-3461.

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* 1. This survey is being completed by

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