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Disability Cultural Center
San Francisco
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Thank you for coming to the DCC!
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Contact Information
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Last Name
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What is your relationship to San Francisco? Check all that apply.
I live in San Francisco
I work or go to school in San Francisco
I live in the Bay Area and visit San Francisco often
I used to live in San Francisco
I have no meaningful relationship with San Francisco
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Access Information
What are your access needs? Select all the apply.
ASL
Audio description of visual materials
Captions
Chemical or scent-free environment
Indoor
Indoor and Outdoor
Low-stimulation or quiet space
Masks optional events
Masks required events
Outdoor
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Dietary restrictions/allergies
Dairy-free
FODMAP intolerance
Gluten-free
Low sodium
Vegan
Vegetarian
Allergy (please specify)
Additional
Allergies
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Do you require outdoor seating in order to join us?
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It’s helpful for our programs and funding to understand demographics. Are you willing to share a bit about your background/identities?
I have previously provided my demographic information
Yes, I will share demographic information to support the DCC
No, I prefer not to share demographic information
Background and Identities
Race
Indigenous / Native American / American Indian / Alaska Native
Black / African American / African
Asian American
Latine / Latinx / Hispanic / Latin American
Middle Eastern / North African
Native Hawaiian / Pacific Islander
White / Caucasian / European American
Additional
Prefer not to say
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Gender (Please select the one that best fits)
Agender
Intersex
Gender Expansive/Nonbinary
Cis Man
Questioning
Trans woman
Trans man
Two Spirit
Cis Woman
Additional
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How would you describe your finances?
Struggling to make it work
Meeting basic needs
Meeting basic needs with a little extra
Comfortable with some disposable income
Financially thriving with lots to spare
Prefer not to share
Sexual Orientation (Please select the one that best fits)
Asexual/Aromantic/Demisexual
Bisexual/Pansexual
Gay/Lesbian
Queer
Questioning
Straight/Heterosexual
Additional
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Birth year
Check all conditions that you currently experience:
Blind / low vision
Chronic Illness (HIV/AIDS, Cancer, MCS, MS, etc.)
Chronic pain
Deaf / Hard of Hearing
Intellectual / developmental disability
Large size / fat
Learning disability (dyslexia, dyscalculia, dysgraphia, etc.)
Limb difference / amputee
Little person / short stature
Mental health condition (anxiety, depression, schizophrenia, bipolar, PTSD, etc.)
Mobility disability
Neurodivergent (ADHD, memory loss, autistic, TBI, OCD, etc.)
Substance abuse/addiction
Additional
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Community Agreements
Treat the space with care.
Keep the space sparkly and clean. If there is a spill or break, please let the DCC team know as soon as possible.
Be gentle with the equipment, fixtures, walls, and furniture. Ask for help if you don’t know how to operate something.
We all make access happen.
Please do not use scented products before coming to the DCC or at the DCC. If you arrive with a scent on, you may need to spend most of your time on the patio.
If you bring a service animal, please follow the
Service and Support Animal Policy
at all times.
Be aware of your sound in the shared space. Do your best to control your voice volume and use headphones when listening to things.
Please follow the
Mask and Illness Policy
and only come to the center on the days that feel appropriate for your needs.
We ask that members enter the DCC space ready to work together and co-create a community of care.
Get consent.
Consent is very important any time we share space. Consent at the DCC could be about seating choices, photography, conversations, receiving help, and many other things.
Before you enter someone’s space or conversation, please get consent. You could ask, “May I join you?”
We recognize that consent is complicated. If you need communication support, please feel free to ask a DCC team member.
Get consent before taking photographs and sharing any personal information or images outside the DCC.
Resolve conflicts with care.
Mistakes will happen, and learning is an essential part of this community. We ask that members learn and grow with patience and curiosity.
These member agreements are not meant as a tool for control. If you feel the agreements are not being met, please help each other with care.
If you need support finding a solution to a conflict, please ask a DCC team member.
I will follow the San Francisco Disability Cultural Center’s Community Agreements.
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Consent to Share Information
Do you agree to the following terms:
The San Francisco Disability Cultural Center, a project of L.C. and Lillie Cox Haven of Hope ("HoH"), works in partnership with the City and County of San Francisco. By submitting this information, you consent to these three entities publicly sharing this information without any personal identifying information. Your name, contact information, and all other potentially identifying information are for HoH and DCC internal use only. This potentially identifying information will never be shared with third parties, unless required by law.
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