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Home
About Us
Staff Profiles
Our Values
Our Services
Gallery
Support
Day Care
Careers
News
Newsletter
Facebook Feed
Instagram Feed
Contact
Login
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The Bee Hut:
Expression of Interest
The Bee Hut: Expression of Interest
Choice Support Plus
2024-10-07T03:44:11+00:00
First name
*
Last name
*
NDIS Number
*
Gender
*
Male
Female
Non-Binary
Other
Date of Birth
*
Please note we only provide support to people seven (7) years and older
Address
*
Suburb
*
Postcode
*
Home phone
*
Mobile
*
Email
*
Emergency Contact
*
Relationship
*
Home phone
*
Mobile
*
Work
*
Please tick which programs you are interested in.*
Cooking program
Art Therapy
Social outings
Music
Crafts
Movie nights
Games nights
Do you have?
A Complex Care Plan?
*
YES
No
A Behavioural Support Plan?
*
YES
No
Your own transportation to the day centre?
*
YES
No
If not – Do you have transport funding?
*
YES
No
What is your disability? Please tell us about any specific diagnosed disabilities or conditions, including any secondary conditions, medical concerns, or chronic illness (e.g. Autism spectrum disorder, intellectual disability, physical disability, mental health condition, hearing or vision impairment):
*
Do you take any medications or treatments that may require monitoring or administration during the day service program?:
*
Do you have any behavioural challenges or require specific behavioural supports?:
*
Do you currently, or have you ever?
Suffered from anxiety?
*
YES
No
Had difficulty being in a group environment?
*
YES
No
Been at risk of falling?
*
YES
No
Had mobility issues?
*
YES
No
Utilised assistive technology or mobility aids?
*
YES
No
If so, please let us know what mobility aids you utilise:
*
Do you require assistance with personal care? If so, what areas of personal care do you require assistance with?
*
Do you have any speech/language impairments, or do you have specific communication needs?:
*
Do you have any sensory sensitivities or sensory processing disorders?:
*
Do you have any specific allergies or diet restrictions?:
*
What activities would you like to see at The Bee Hut?
*
Do you have any other comments or suggestions? eg: Male or Female support staff preference
*
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