HUGS Student Profile

Thank you for taking the time to fill out this form with as much detail as you can provide. This information helps us welcome your student, keep them safe, and ensure their experience at LifePoint Church reflects God's love for them.

Please note: this digital form is for intake purposes only and will be deleted after intake is completed.

Your name *

Email address *

Household Information

Are you and your family new to LifePoint?

Student's Information

Please fill out the following info only for any student who will be participating in our HUGS ministry.

Student's Name *

First and Last

Student's Birthday *

Approximate Developmental Age *

Specific Disabilities *

Communication

Is your student verbal? *

Hygiene

Can your student use the toilet? *

What, if any, additional assistance does your student need to use the bathroom?

Interests & Activities

What activities does your student enjoy? *

Diet

What food allergies or dietary restrictions does your student have, if any?

Seizures

Does your student have seizures? *

Behaviors

How does your student show frustration? *

Does your student ever exhibit aggressive behaviors toward themselves or others? If so, please explain:

(i.e., head banging, hitting or biting themselves or others)

What is the best way to calm your student if they become upset? *

Are there any other potential behaviors we should know about?

Please Note: Nothing surprises us or makes us nervous, we simply want to be prepared to welcome your student, keep them safe, and ensure their experience at LifePoint Church reflects God's love for them.

Other Needs

Does your student have other needs you would like us to be aware of?

Describe any physical, social, emotional, or spiritual needs you'd like us to be aware of.

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