Dac Message 539

<b>Mobility</b><br>
Check this box if you have a mobility disability that has been adversely affected by the disaster.<br><br>

<b>Cognitive/Developmental Disabilities/Mental Health</b><br>Check this box if you have a cognitive/developmental disabilities or mental health disability that has been adversely affected by the disaster.<br><br>

<b>Hearing or Speech</b><br>
Check this box if you have a hearing or speech disability that has been adversely affected by the disaster.<br><br>

<b>Vision</b><br>
Check this box if you have a vision disability that has been adversely affected by the disaster.<br><br>

<b>Other</b><br>
If you have some other special needs that were affected by the disaster that are not mentioned above, please type in a word or phrase to describe the special needs.