Accommodation Card

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Create an Accommodation Card

Use the form below to create an accommodation card. It will allow you to create a personalized accommodation message. Select the appropriate values from the lists. When finished, click on the “Create Card” button below to create your accommodation card. Print the card and keep it with your other identification cards.

This is created by Daryl Dolan in consultation with the Behavioral Health Task Force for Persons who are Deaf, DeafBlind and Hard of Hearing.

To make an accommodation Card, I am:

Deaf

I am deaf.

To communicate effectively, I need:













Who to contact for what I need:
Example: an interpreter agency and its phone number


In case of emergency, contact:
Example: your relatives and their phone number


Select your State:

Hard-of-Hearing

I am:


To communicate effectively, I need: (check all that apply)



















Who to contact for what I need:
Example: an interpreter agency and its phone number


In case of emergency, contact:
Example: your relatives and their phone number


Select your State:

DeafBlind

I am:  

My full name is

To communicate effectively, I need: (check all that apply)













Who to contact for what I need:
Example: an interpreter agency and its phone number


In case of emergency, contact:
Example: your relatives and their phone number


Select your State:


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