Contact Information
Name*
Title
Company
Address*
Email*
Mobile Phone Number
All registration is digital to help reduce the amount of contact onsite. Please provide your mobile device number below to help facilitate that effort. By entering in your mobile phone number, you agree to receive messages via SMS/MMS regarding Abilities Expo.

Demographic Information

*Are you a healthcare professional?
Yes
No
*Are you a person with a disability?
If yes, is the disability: (check all that apply)
Mobility Upper Limb Amputee
Lower Limb Amputee Vision
Hearing Developmental
Autism Spectrum Disease/Illness
Cognitive Sensory
Other
Please Specify:
If you are not a person with a disability, are you a...?(check all that apply):
Friend/Family Member
Caregiver
Healthcare/Disability Professional
Dealer/Distributor
Manufacturer
Other
Please Specify:
*Have you attended a past Abilities Expo?
Yes, I have attended.
No, I have not.
*Why did you decide to visit Abilities Expo? (Check all that apply.)
Latest disability products and services
Informative workshops
Adaptive activities like sports, dance and more
Networking
Other
Please Specify:
*What is your gender?
Male
Female
Other
Please Specify:
*What is your age?
*In the next 12 months or sooner, do you intend to purchase any of the following? (check all that apply)
AAC devices Accessible Vehicle
Adaptive Clothing Assistive Technology
Daily Living Aids Deaf/Hard of Hearing Products
Healthcare Provider/Equipment Home Medical Equipment/Furnishings
Lifts/Ramps Low Vision/Blind Products
Pediatric Equipment Scooters/Accessories
Service Animal Sports/Fitness/Recreation
Therapies Travel
Walker/Cane/Crutch/Accessories Wheelchair (Manual)/Accessories
Wheelchair (Power)/Accessories Just Browsing
Other
Please Specify:
Click here if you would prefer NOT to receive the Abilities Buzz, an e-newsletter that conveys valuable information about people with disabilities and Abilities Expo events.
No, I do not wish to receive the Buzz.
We'll have a SPECIAL FILM SCREENING of The Power to Move at 10am before the show opens on Saturday, December 6. Click here if you would like to attend and we will email you FREE TICKETS.
Click here if you would like to receive free tickets to attend the award-winning documentary, The Power to Move.

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