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Altona Accessibility by Equal Access Altona

Demographic Information

This section allows us to collect basic, non-identifying information about you.  Your information will remain anonymous and confidential.  We use this information to get a better understanding about the people we support in the community.  
1. Are you... *This question is required.
2. If you are an individual who has a disability, what type of disability do you have? *This question is required.
3. What supports are you currently receiving to assist with your disability? *This question is required.
4. How old are you? *This question is required.
5. Do you currently live... *This question is required.