We inquire about certain health issues out of respect for the needs of each individual person and of the needs of community. Your openness to discussing past and current medical and mental health concerns helps QVS know how best to support you and your community during the upcoming year. We ask you these questions so that we can understand your needs and so that you can learn about the support QVS has to offer you and what is beyond our ability to support. We ask that you complete this form with honesty and accuracy, to the best of your knowledge.
All information will be kept confidential.