CLASP is interested in learning about local suppliers and manufacturers. Do you have a small business manufacturing assistive products? We’d like to hear from you and learn more about your business. The information that you share will be compiled by CLASP so that we can refer interested buyers and service providers when possible. Please fill out this form and someone from our team will be in touch with you soon.

Company Name*

Company Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Name*

First Last

Phone Number*

Email Address*

Your Job Title

Which types of assistive products do you manufacture?*

How long have you been in the assistive products business?*

Company sales volume last year? (Including currency)*

How did you hear about us?*

Supplier Questionnaire