B. A
person with a disability (i) has a long-term or recurring
physical, mental, sensory, psychiatric or learning impairment
and
a) consider himself / herself to
be disadvantaged in employment by reason of that impairement,
or,
b) believes that an employer or
potential employer is likely to consider him/her to be disadvantaged
in employment by reason of that impairment,
and includes persons whose
functional limitations owing to their impairment have been
accommodated in their current job or workplace.
ARE YOU A PERSON WITH A
DISABILITY
No
Yes,
check all that apply
11 Co-ordination or dexterity (difficulty using
hands or arms, for example, grasping or handling a stapler or using
a keyboard)
12 Mobility
(difficulty moving around, for example, from one office to
another or up and down stairs)
16 Blind or
visual impairment (unable to see or difficulty
seeing)
19 Deaf or hard
of hearing (unable to hear or difficulty
hearing)
13 Speech
impairment (unable to speak or difficulty speaking and being
understood)
23 Other
disability (including learning disabilities, developmental
disabilities and all other types of
disabilities)
(Please specify)
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