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Friend

Parent/Caregiver Name:* Parent/Caregiver Name is Required

Participant's (Friend's) Name:* Participant's (Friend's) Name is Required

Friend's Birthdate:* Friend's Birthdate is Required

Phone:* Phone is Required

Billing email:* Billing email is Required

Class Info Email, if different:* Class Info Email, if different is Required

Parent or Caregiver:* Parent or Caregiver is Required

Parent Caregiver

Provide a short description of the Friend (personality, likes/dislikes, what motivates them to do non-preferred activities, etc): Provide a short description of the Friend (personality, likes/dislikes, what motivates them to do non-preferred activities, etc) is not valid

FLC likes to know the top 3 goals of our Friends so we can support and encourage them. Please list your Friend's top 3 goals.: FLC likes to know the top 3 goals of our Friends so we can support and encourage them. Please list your Friend's top 3 goals. is not valid

Please describe your Friend's communication (fully verbal, partially verbal, uses communication device). Any helpful words for us to know or understand?: Please describe your Friend's communication (fully verbal, partially verbal, uses communication device). Any helpful words for us to know or understand? is not valid

Please rate the Friend's skill level of speaking and standing with confidence: Please rate the Friend's skill level of speaking and standing with confidence is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level of self-advocating their wants and needs: Please rate the Friend's skill level of self-advocating their wants and needs is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in expressing herself/himself with creativity: Please rate the Friend's skill level in expressing herself/himself with creativity is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level of self-initiating progress towards goals: Please rate the Friend's skill level of self-initiating progress towards goals is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in completing at least 90 minutes of activity/exercise per week: Please rate the Friend's skill level in completing at least 90 minutes of activity/exercise per week is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in maintaining a healthy weight: Please rate the Friend's skill level in maintaining a healthy weight is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in cleaning up after herself/himself: Please rate the Friend's skill level in cleaning up after herself/himself is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill in completing a personal hygiene routine: Please rate the Friend's skill in completing a personal hygiene routine is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in contributing to responsibilities at home: Please rate the Friend's skill level in contributing to responsibilities at home is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in following a checklist (visual or verbal): Please rate the Friend's skill level in following a checklist (visual or verbal) is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

Please rate the Friend's skill level in following verbal directions: Please rate the Friend's skill level in following verbal directions is not valid

High/Has mastered this skill Medium/Some of the time Low/Rarely/Needs direct support

How did you hear about Friends Life Community?: How did you hear about Friends Life Community? is not valid

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Mission: To provide an opportunity for teenagers and adults with disabilities to develop socially, grow personally, and enjoy community as they experience life together.

Address: 4414 Granny White Pike, Nashville, TN 37204
Phone: (615) 730-9370

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