Description of Participant Needs
Please list any diagnoses that we should be aware of:
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Allergies: food, drug, environmental
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Dietary restrictions
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Please describe any heart conditions:
Medications: names and dosage (please list all regular medications. In case of emergency, we will need to have this information on hand)
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Please Describe
Seizure details
Wheelchair or adaptive equipment details:
What things do they love? (music, characters, games, activity, food, etc.)
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How do they do in a group setting?
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Would they be more comfortable in an age-group that is different than their chronological age?
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Would the participant be best cared for in a one-on-one situation?
Are there any fears we need to know about? (stranger anxiety, people in costumes, dogs or other types of animals, loud noises, etc.)
Does this participant have difficulty with transitions? (starting/stopping activities, moving to different locations, etc.)
Are there any other safety issues that we need to know about? (elopement risk, aggression when stressed, etc.)
We typically offer a light snack at our events. Are there any feeding issues we need to know about? (choking risks, over eats, needs extra assistance, etc.)
Sometimes our events have an outdoor component. Are there any concerns about indoor versus outdoor activities? (overheating, too cold, sun sensitive, elopement risk, etc.)
If this participant becomes upset, what are the best ways to soothe them? What strategies are used at home/school? (rocking or singing to them, giving them space, quiet area, redirect with new activities, etc.)
Please feel free to add any additional information that you would like to share with us here. The more we know about your loved one, the better equipped we will be to provide the highest quality of care possible.
If you are human, leave this field blank.
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