CDAC Database Application

Your Name *

Your Email *

Your Postal Code *

Your Telephone Number *

I identify as gender as: *
MaleFemaleNon-binary / 3rd GenderI prefer not to discloseOther:

You must agree to ALL of the following statements in order to be listed on the CDAC database. Please review these statements and click “Agree” at end. Please do not submit an application if you are unable to agree with any of these statements.

• I have successfully completed the CDAC Communication Assistance Course

• I have at least 12 months experience working with a person who has a disability or with a disability organization.

• I can provide a resume and reference(s) for my work in disability services.

• I understand my role is to facilitate two-way communication between a person who is over 18 years of age, has established ways to communicate and another person(s).

• I understand that my attendance at the communication assistance course has not prepared me to conduct communication assessments, provide therapy or clinical services. In addition, it has not prepared me to recommend or program communication devices or develop communication displays.

• I understand that at this time, Communication Assistant is not a professional title or qualification.

• I understand that a Speech-Language Pathologist should support a person communicating in critical situations such as with police, legal or justice situations, or in healthcare settings relating to consent to treatment and capacity assessments.

• I will only take on work engagements where I have experience working with people who have similar disabilities and who use similar communication methods.

• I have proficient speaking, reading, spelling and writing skills in English or French (at least grade 4 level).

• I understand that I am accountable to the person who is hiring me to assist with communication. CDAC does not pay, employ or endorse my work as a communication assistant.

• I understand that the information I provide for the database is true and will only be used by CDAC on the assistance database.

• I understand that it is my obligation to respond to finder requests that I might receive for communication assistance.

I agree with all these statements *
Yes

I have experience supporting people with the following disabilities. Check all that apply. *
AphasiaIntellectual DisabilityAmyotrophic Lateral SclerosisAutism Spectrum DisorderAcquired Brain InjuryCerebral PalsyDementia and Alzheimer’s diseaseMultiple SclerosisParkinson’s diseaseHuntington’s ChoreaOther:

I have experience supporting people who use the following communication methods. Check all that apply. *
Unclear speechLetter /Alphabet DisplayPicture communication displaySymbol communication displayCommunication deviceOther:

Please write a short paragraph (no more than 6 sentences) about yourself and your experience supporting people who have communication disabilities. You could include information on where you have worked or if you are a personal support worker, attendant, family member, direct service provider, or a volunteer in a disability organization. Tell us if you have extra training to support people with specific disabilities, such as supported conversation for adults with aphasia.

This information will be put on the communication assistance database. Your name will not be provided.