ALL ABILITY GARAGE

All Ability Garage

Shed 10c 43-47 Morayfield Rd, Caboolture South 4510

www.allabilitygarage.com

admin@allabilitygarage.com

Cameron Garth - 07 5328 1180

Participant name

Contact Number

Email address

example@example.com

DOB

Address

Preferred contact method

Participant Representative Details (if applicable)

Name

Contact Number

Address

Relationship to Participant

NDIS Participant Number

NDIS Plan Dates (start and end)

Date

Plan Manager Name

Plan Manager Agency

Plan Manager Email

example@example.com

NDIS Recognised Diagnosis/Diagnoses

Medications All Ability Garage require to know if you are on any medication which may impact your focus, concentration, energy levels etc. and whether these need to be managed or concessions made within support sessions

All Ability Garage require to know if you are on any medication which may impact your focus, concentration, energy levels etc. and whether these need to be managed or concessions made within support sessions

Other medical diagnoses if relevant

Preferred Support Session timeslot

Select Time slot

8:00am to 12:00 Noon1:00PM to 4:00PM

is transport required for you to attend All AbilityGarage

YESNO

If yes, would you like All Ability Garage and associatesto arrange Transport to and from All Ability Garage

YESNO

if Yes, address to be picked up (state ‘As Above’) if from Home Address

AS ABOVE ADDRESSNOT REQUIREDOther

Will you have your own Support Person present at sessions

YESNONOT REQUIRED

Are you interested in weekend supports/activities when available

YESNO

Do you have your own project or vehicle you wish to work on

YESNOWILL DO IN THE NEAR FUTURE

IF YES Do you require transport of your project or vehicle to All Ability Garage

YESNOOther

Do you declare you are fit and able to operate power tools and equipment, to learn how to operate tools and equipment safely, under guidance

YESNOOther

Skills you will learn through All Ability Garage:

Improving social skills: how to effectively and respectfully communicate with your peers; how to work under direction and with guidance; establishing and maintaining new relationships

Improving emotional regulation: opportunities to implement strategies around emotional regulation, improving your advocacy skills for yourself, and opportunities to discuss impacts and challenges with peers, receiving peer-led support through support sessions

Improving knowledge: opportunities to improve your knowledge around vehicles; how they operate, maintenance schedules, how to complete services, how to complete minor and moderate modifications where relevant

Improving work-readiness: opportunities to engage in a workshop-like environment, where you willbe required to listen, understand and implement set tasks. Opportunities to improve skills in taking directions, seeking assistance when needed, and following safety protocols

Improving well-being: opportunities to form solid relationships with peers to reduce social isolation; opportunities to bond with peers over shared interests; opportunities to engage in further activities of interest

Are there any particular skills you wish to learn through All Ability Garage? Example: how to maintain a vehicle; how to prepare paint and panel for a vehicle; how to wire electronics; how to weld; how to prepare for a car show or race meet

Example: how to maintain a vehicle; how to prepare paint and panel for a vehicle; how to wire electronics; how to weld; how to prepare for a car show or race meet

Are you interested in engaging in support sessions that solely focus onone particular skillset; EG (sessionswill be run by qualified tradespeople and will occur outside of regularsupport sessions)

How to WeldHow to repare panelBasic Auto ElectricsOther

ALL ABILITY GARAGE

NEW PARTICIPANT INTAKE FORM