Voluntary Self-Identification of Disability

Form CC - 305

OBS Group Inc. provides equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. At OBS Group Inc. we measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it.

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

• Alcohol or other substance use disorder (not currently using drugs illegally)

• Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS

• Blind or low vision

• Cancer (past or present)

• Cardiovascular or heart disease

• Celiac disease

• Cerebral palsy

• Deaf or serious difficulty hearing

• Diabetes

• Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders

• Epilepsy or other seizure disorder

• Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome

• Intellectual or developmental disability

• Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD

• Missing limbs or partially missing limbs

• Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports

• Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)

• Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities

• Partial or complete paralysis (any cause)

• Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema

• Short stature (dwarfism)

• Traumatic brain injury