Side-By-Side Registration Question Title * 1. Name of group participant: Question Title * 2. Name of Care Partner: Question Title * 3. Contact Information: Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 4. What CURRENT hobbies or interests does the group member enjoy? Question Title * 5. What was the group member's previous occupation? Question Title * 6. What are the group member's typical daily activities / routines? Question Title * 7. Tell us about the group member's: Attention Span Memory Ability to follow multi-step directions Communication abilities and preferences Question Title * 8. Does the group member experience any of the following (Select all that apply) Anxiety or difficulty in unfamiliar spaces? Searching for you when out of sight? Frequent restroom visits or needing help toileting? Other (please specify) Question Title * 9. If you indicated any of the previous support needs, is the group member enrolled in Project Lifesaver? Yes No, I am not interested in PLS. No, but I am interested in learning more. Not applicable (I did not choose any of the above) Question Title * 10. Does the group member experience any of the following? Easily frustrated when overstimulated? Need assistance sitting / standing? Question Title * 11. What topics or subjects does your loved one enjoy? Question Title * 12. What topics or subjects should be avoided? Question Title * 13. Is there anything else that you would like us to know? Done