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Individual Profile Submission
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Step
1
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Community Living Agency's Information
What is your community living agency name?
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What is the name of the contact person?
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First
Last
that experience for
What is the contact person’s position?
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What is the contact person’s email address?
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By continuing, I confirm that I will not include any personal or identifying information about any individual, in order to maintain confidentiality.
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I confirm
Next
Individual's Information
Is this individual looking for a home sharing provider or a respite provider?
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Home sharing provider
Respite provider
Is this individual looking for reverse home sharing?
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Yes
No
Reverse home sharing means the home sharing provider lives in the individual’s home, rather than the individual moving into the home sharing provider’s home.
How are living costs, such as rent and utilities, arranged for the reverse home sharing provider?
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Please provide a brief introduction of the individual, such as hobbies, daily schedule, and preferred locations.
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What is the level of supports for this individual?
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Low support needs
Moderate support needs
Complex support needs
What are the areas of support for this individual?
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Communication
Meeting personal care needs
Creating or maintaining relationships
Making day-to-day decisions
Making important life decisions
Safety within community
Work and learning
Community participation
Complex health needs
Complex support needs
What are the key responsibilities when supporting this individual?
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What knowledge or experience should a provider have to best support this individual?
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