The Day D.E.N Program Application Logo
  • The Day D.E.N Program Application

    Please Fill Out Each Section and Upload Your Supporting Documents
  • Day D.E.N. Rules Document
    Please review the Day D.E.N. rules before completing your application:
    🔗 Click here to view the Day D.E.N. Rules

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  • Support Services Disclaimer for Day D.E.N. Participants

    ROAR Florida does not provide individualized support services for participants in the Day D.E.N. program. It is the responsibility of applicants, their legal representatives, and/or family members to ensure that any necessary supports are in place before participation. We recognize that some individuals may require assistance in specific areas in order to fully and safely engage in our programming. Therefore, as part of the application process, confirmation must be provided by the applicant and/or their legal representative that adequate support is already in place for program participation.
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  • Legal Representative or Primary Contact Information

  • Basic medical information


  • Dietary Needs & Skills

  • Safety Skills

  • Transportation Skills

  • Mental Health and Behavioral Supports


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  • Expectations

  • Consent to Disclose Personal and Health Information & Applicant Acknowledgment

    I, the undersigned applicant or legal representative, give ROAR Florida permission to collect, store, and disclose relevant personal and health information provided as part of the application and participation in the Day D.E.N. program. This includes, but is not limited to, medical history, diagnoses, medications, emergency contacts, and any other information necessary to support safety and informed program participation. I understand that this information will be kept confidential and stored in accordance with all applicable regulatory requirements and/or best practices. Information will only be shared with staff or professionals on a need-to-know basis to support the safety and well-being of the applicant. I understand that completion of this application does not guarantee acceptance into any of ROAR Florida's Day D.E.N. programs. I affirm that all information provided in this application is true and accurate to the best of my knowledge and that no relevant information has been knowingly omitted.
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