Illinois IMPACT Enrolled Provider Survey












If yes, please select the types of home modifications you provide.


If yes, please select the category(ies) of vehicle modifications you provide.


If yes, please select the category(ies) of remote support you provide.


If yes, what type of adaptive equipment and/or assistive technology services do you provide?
If yes, please also identify the categories of adaptive equipment OR assistive technology that you provide.
Check all the counties that your company serves: