Communication Access Form
The Communication Support Questionnaire Form is a form you can download and complete to tell people about your communication access needs. It’s useful when:
- Communicating with people who don’t know you.
- Communicating with businesses and services, such as healthcare providers.
- Communicating at a meeting or a public event.
- Communicating over the telephone.
- Getting written information in ways you can read and understand.
- Completing forms, taking notes and signing documents.
You can put these instructions on a card or program them into your device.
Click here to get the form: Communication Support Questionnaire Form
You may want to discuss your accessibility requirements with your Speech-Language Pathologist or Augmentative Communication Clinician.
Here are some things to consider including on the form.
- How you communicate. For example, have phrases to tell someone how you signal yes and no.
- What people should do when communicating with you. For example, have phrases to tell someone to read the letters that you point to on your board.
- Whether you need extra time to communicate. For example, have phrases to tell someone you need an extra 15 minutes appointment because it takes you longer to communicate.
- What you want people to do if they do not understand your message. For example, have phrases to tell someone to let you know if they don’t understand your messages.
- What you want people to do if you can’t understand what they are saying. For example, have phrases to tell someone to explain things or to show you what they mean.
- How you want to connect with them when not physically present such as using the telephone, email, text or social media. For example, have phrases to tell someone that you want to use text rather than the telephone.
- How you want written information given to you. For example, have phrases to tell someone you want a document in plain or everyday language or large font.
- Whether you want any support to complete forms, or take notes.
- Any special instructions you have about how you sign documents.
- Whether you want an organization to provide you with a communication assistant to support you communicating at a public events, committee meetings, conferences etc.
- Whether you need a communication intermediary to assist you communicating with police, lawyers and justice professionals.
- In a hospital or healthcare setting, have phrases to tell service providers who you want to assist you with communication. You may need to explain that you make your own decisions, not the person who assists with communication or that you want a trusted person to assist you make decisions.
Resources
Communication Support Questionnaire Form
Guidelines to make your communication access card
- Things to consider when making your Communication access card. This card tells people how to make their services communication accessible to you.
- You can type or write in your instructions on this card. Then you can print it and laminate it. Keep it in a place that you can easily show it to people.