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CAN Endorsement

1. CAN Feedback

Thank you for participating in CAN. We value your contribution and endorsement.

Question Title

* 1. I support the need for communication access to all businesses, organizations and especially to healthcare, emergency and justice services for people who have communication disabilities.

Yes

No

Other (please specify)

Question Title

* 2. We would like to know who you are so that we can send you updates on CAN and other CDAC projects. Your information will be treated as confidential and will not be shared outside of CDAC. Please note that you do not have to provide this information.

Name:

Work place:

Address:

Address:

City/Town:

Province

Postal Code:

Country:

Email Address:

Question Title

* 3. Tell us about yourself. Please note that you do not have to provide this information.
Are you

Person with a communication disability

Clinician, service provider or advocate

Family member of a person with a communication disability

Person who works in a community business, organization or service

Other (please specify)

Thank you.