This questionnaire is tailored toward gaining a better understanding of the potential traveler’s level of functioning in the areas of socialization, independence and over-all level of functioning. A more detailed medical evaluation will be required to be completed once your traveler has been accepted into our program.
Important: Please answer the following questions to the best of your ability with complete honesty with regard to your answers. Remember, this is a program for those with special needs. We need to know about strengths and weaknesses to better service your traveler’s needs. Therefore, answering questions honestly and fully will contribute to a successful summer experience for all.
This is an interactive form. Please complete all Steps 1-6 and submit when all fields are completed.