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Health Insurance: Policy Number: Medical Disability Diagnosis: Any Physical Limitations:
Please, describe your individual independent skills.
Do you have any behavioral concerns?
Do you need constant supervision?
Please, list the information for anyone that will provide respite services.
Name, phone number
Please, share your hobbies and interests.
Please, share what volunteer service you are interested in participating in.
Are you interested in improving your self-esteem and learning how to become a self-advocate?