NOTA WILL BE CLOSED IF ORION AND OXFORD SCHOOLS ARE CLOSED DUE TO THE WEATHER
NOTA WILL BE CLOSED IF ORION AND OXFORD SCHOOLS ARE CLOSED DUE TO THE WEATHER
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Professional Name(Required)
DOB_af_date
MM slash DD slash YYYY
Applicant Name(Required)
Social Worker
Physician
PT/OT
Counselor
Nurse Practitioner
Other
Temp No
Temp Yes
Motor Wheelchair
Walker
Wheelchair
Crutches
Service Animal
Cane
Leg Braces
Power Scooter
Other
Blind Yes
Blind No
Cognitive Yes
Cognitive No
Exceed 400 lbs Yes
Give Address No
Give Address Yes
Give Address Sometimes
Landmark Yes
Landmark Sometimes
Landmark No
Change Yes
Change No
Change Sometimes
Follow Diections Yes
Follow Directions No
Follow Directions Sometimes