Hispanic/Latino if client is a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race. Includes persons from the Dominican Republic.

Disability is defined as a physical or mental impairment that substantially limits one or more of the major life activities including but not limited to: Caring for oneself, performing manual tasks, seeing hearing, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning reading, concentrating, thinking, communicating, interacting with others, and working; and the operation of a major bodily function, including functions of the immune system, special sense organs and skin; normal cell growth; and digestive, genitourinary, bowel, bladder, neurological, brain, respiratory, circulatory, cardiovascular, endocrine, hemic, lymphatic, musculoskeletal, and reproductive functions. The operation of a major bodily function includes the operation of an individual organ within a body system; or has a record of such impairment, or is regarded as having such an impairment.

Mental or psychological disorders can include intellectual disabilities, organic brain syndrome, emotional or mental illness, and specific learning disabilities. Examples include, but are not limited to: Attention-deficit hyperactivity disorder (ADHD), dyslexia, aphasia, brain injury, language delay or learning disabilities, autism, cerebral palsy, brain injury, Down Syndrome; Depression which affects a person’s mood, concentration, sleep, activity, appetite, social behavior and feelings; Bipolar disorder (manic depression) which causes a person to experience extreme highs and lows; Schizophrenia which affects a person’s ability to think clearly, manage emotions, make decisions and relate to others; Post-Traumatic Stress Disorder (PTSD) which occurs after exposure to a terrifying event or ordeal; Obsessive-Compulsive Disorder (OCD) which causes intense recurring unwanted thoughts (obsessions) or rituals (compulsion); Panic Disorders which cause unexpected and repeated episodes of intense fear accompanied by physical symptoms such as chest pain, heart palpitations, shortness of breath, dizziness or abdominal distress.

If “Yes” was marked indicating that the individual has a disability, identify the accommodation needed to participate in our program(s).

LEP is defined as being unable to speak, read, write or understand the English language at a level that permits them to access services in a meaningful way.