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<b>Other Needs</b></p>

<p>The Americans with Disabilities Act (ADA) defines disability as &quot;a physical or mental impairment that substantially limits one or more of the major life activities of such individual,&quot; 42 USC 12102(2)(A). If you or a household member have such a disability, select <b>Yes</b>. If yes, check all that apply, or select <b>Prefer Not to Answer</b>.</p>

<p>If you or a household member had any disability-related assistive devices or medically required equipment, supplies, or support services damaged, destroyed, lost, or disrupted because of the disaster, select <b>Yes</b> and check all that apply.</p>