Patillas services fair

Grief in families when diagnosed with a disability 
Resource: Dr. Solymar Alicea, clinical psychologist
Thursday, May 16, 2024

 

Name *

Surnames *

Telephone numbers

Email *

Town *

Residence area: *UrbanRural

Which category best describes you? You can check more than one.FamilyDisabled personProvider of services to the population with disabilities

Other:

My education is: *Elemental schoolMiddle SchoolHigh schoolVocationalPost secondaryOther:

If you answered "Other" in the previous question, specify your educational level:

My race is: *WhiteAfrican AmericanNative AmericanAsianTwo races or moreI don't want to disclose itOther

Other:

My ethnicity is: *Hispanic or LatinaNot Hispanic or LatinoI don't want to disclose it

Age of the person with a disability for whom I care or work

Diagnosis of the person with disabilities for whom I care or work

Do you require reasonable accommodation?

I agree

I understand that the activity will be in person at the Public Car Terminal in Patillas, PR

Send