Allergen/Accessibility Survey Question Title * 1. Do you have any food allergies? Yes No Question Title * 2. If so, what are they? Question Title * 3. Are they airborne or by consumption? Airborne Consumption Question Title * 4. Are they life-threatening or require medical attention? Yes No Question Title * 5. If yes, do you carry an epi pen or other anaphylaxis aid? Yes No Question Title * 6. Do you have any accessibility requirements? Yes No Question Title * 7. If so, what are they? Please explain in detail much as you are comfortable with and suggest some solutions to help you during the meetings. Auditory Physical Speech Visual Other Question Title * 8. Councillor Name: Done