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PSO 2855 - Inside Time

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<strong>PSO</strong> <strong>2855</strong> Page 154. Please tick any of the following which apply to you.Hearing impairment Reduced physical capacityincluding difficulty withphysical co-ordinationSpeech impairmentSevere disfigurementVisual impairmentMental illness(NOT corrected by glasses orcontact lenses)Reduced mobilityLearning difficultiesProgressive condition (e.g.cancer, muscular dystrophy)DyslexiaOther (please specify)No disabilitySignature……………………………………Issue No. 295 Issue date 3/04/08

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