COVID-19 Disability Form for Vermont

Why Should You Fill Out This Form?

We are worried that a lot people will get the Coronavirus at the same time. Your hospital may have too many people to help all at once. They may say you cannot have any visitors. Talk to your team. Think about what support you need if you must stay in the hospital.

The form below was adapted by Green Mountain Self-Advocates for use in Vermont. You can find a similar form for your state at:

Preparing Individuals with Intellectual/Developmental Disabilities for Medical Treatment at Hospitals

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