Be Matched with Our Members

List any and all diagnoses, disabilities, difficulties, or limiting conditions you have. They can be anything physical, psychiatric, social, neurological, medical, developmental, learning related, or anything else you feel is related. They do not need to be significant or prevalent. For example, being shy.
This information is essential to what we do. We specialize in supporting people with a wide range of needs, and your honesty helps us make the best possible match for you. Please be as clear and comprehensive as possible.
N/A or None
⚠️ Please either list a diagnosis or check "NA or None" — not both.

About Your Needs and Support System
Do you have a legal guardian? (Someone who legally obtained guardianship of you after you turned 18.)*

YesNoUnknown

About Your Needs and Support System II

We ask for a trusted contact who knows you well and can support or assist in the process if needed.
We ask that you include a parent, close relative or someone relevant in your life. What is their name?*
What's their relationship to you?*
What's their phone number?*
Please enter a valid phone number.
What's their email?*

How do you feel about dating someone who has a disability or is neurodivergent?*

I’m open to itI might be open to it, but would want to learn more about specific situationsI'm not open to it
Please clarify what you feel comfortable with? (Select any that apply.) Click N/A if you selected "I'm not open to it" for the previous question.*

Neurodiversity (e.g., autism, ADHD, learning difficulties)Physical challenges (e.g., wheelchair, cane, braces, or other mobility aids)Mental health difficulties (e.g., anxiety, depression, OCD, bipolar, PTSD)Chronic or Medical conditions (e.g., epilepsy, autoimmune disorders, chronic pain, immunocompromised)N/A
Anything else you'd like to note about this? Or write N/A.*
Your responses are confidential and used only for matching purposes

Basic Information