Diagnosis to assist us process results please use full name of condition with
NO ABBREVIATIONS

Select all items of Equipment Your Child Currently Has at Home/School by clicking the drop down menu
(Hold CTRL key pressed for multiple selection)

none Access & Environmental Control Units (include switches) Communication and AAC Devices, Bathing & Toileting Car Seats Positioning & Sleep Postural Seats Strollers Mobility Bases Manual Wheelchair Powered Wheelchair Sports Wheelchair Standers Walker or Gait Trainer Tray

Please click all equipment items that were funded by CAEP/GOVT
(Hold CTRL key pressed for multiple selection)

none Access & Environmental Control Units (include switches) Communication and AAC Devices, Bathing & Toileting Car Seats Positioning & Sleep Postural Seats Strollers Mobility Bases Manual Wheelchair Powered Wheelchair Sports Wheelchair Standers Walker or Gait Trainer Tray

Time lapse between CAEP application & CAEP funding ie. Time requested funding to actually receiving equipment

Please click all Items of equipment currently needed that your child does not have
(Hold CTRL key pressed for multiple selection)

none Access & Environmental Control Units (include switches) Communication and AAC Devices, Bathing & Toileting Car Seats Positioning & Sleep Postural Seats Strollers Mobility Bases Manual Wheelchair Powered Wheelchair Sports Wheelchair Standers Walker or Gait Trainer Tray

Click items for which you have already applied for CAEP/GOVT funding for?
(Hold CTRL key pressed for multiple selection)

none Access & Environmental Control Units (include switches) Communication and AAC Devices, Bathing & Toileting Car Seats Positioning & Sleep Postural Seats Strollers Mobility Bases Manual Wheelchair Powered Wheelchair Sports Wheelchair Standers Walker or Gait Trainer Tray

Please list amount of time lapsed since your CAEP/GOVT funding application

Is there any equipment you would like to view or trial, that you have not been able to access
(Hold CTRL key pressed for multiple selection)

none Access & Environmental Control Units (include switches) Communication and AAC Devices, Bathing & Toileting Car Seats Positioning & Sleep Postural Seats Strollers Mobility Bases Manual Wheelchair Powered Wheelchair Sports Wheelchair Standers Walker or Gait Trainer Tray

In 200 Words or less, please list any other comments you would like to make in the following categories, your complaints or solutions are both appreciated and can assist us impact government and agency policy.

Access to Fit Equipment Access to Trial Equipment Access to Funding Wait Period for Funding