Please ensure that you fill in every field of this form unless it specifies that it is optional.

If a question does not apply, write “not applicable” or “N/A” in the space.

If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
For example, mobility, communication, behaviour plans.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
If a question does not apply, write “not applicable” or “N/A” in the space.
Carer details

Photographs and video help us spread the word about Sense and our services. We would really like to use some of the great photos/videos taken of you during your holiday this year to promote our work and spread the word about Sense. We will only use the images in a sensitive manner. Please select the following sections to provide your permission.

Please select your activity preferences below

Please select from the below 5 activities 1-5 (1 being your most favourite and 5 being your least). Each participant will be given two activities, and we cannot guarantee your preferred choices.