• Neurospicy SA: Member Intake & Event Waiver

    Welcome to Neurospicy SA! Complete this one-time form for membership, program sign-up, and standing event waiver—registrations require prior approval. You must fill ALL program section required blanks for each program you plan to attend!

  • Personal & Contact Information

    Please fill out carefully and honestly.
  • Format: (000) 000-0000.
  • Date of Birth*
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  • Preferred Method of Contact*
  • Program and Service Interests*

  • Emergency Contact Information

    Please fill out carefully and honestly.
  • Format: (000) 000-0000.

  • Neurodivergent Identity & Diagnosis (Optional)

    This information is voluntary but helps us get to know you.
  • Do you identify as neurodivergent?*
  • Diagnosis & Identity
  • Eligibility and Agreement*

  • Baseline Wellbeing & Community

    All participants complete this section. Your answers help us understand how our programs make a difference. There are no right or wrong answers — this is not a medical assessment.
  • All participants complete this section. Your answers help us understand how our programs make a difference. There are no right or wrong answers — this is not a medical assessment.
  • How often have you felt lonely or isolated in the past month?*
  • How connected do you feel to your community right now?*
  • How would you rate your overall emotional wellbeing this past week?*
  • In the past 6 months, have you participated in community groups or events?*
  • Do you currently have access to mental health or support services?*

  • Adult Socials

    Complete ALL of this section ONLY if you selected Adult Socials above. Otherwise, skip to the next section. Program Description: Neurospicy SA Adult Socials provide safe, supportive spaces for neurodivergent adults (ages 18+) to build friendships, reduce social isolation, and strengthen mental well-being through peer-led programs and community engagement. Format: In-person & online | Admission: FREE (all events) | Duration: 2-4 hours per event | Schedule: 10+ events per month | Events include: movie nights, video games, holiday celebrations, and more. Public events: Must be 18+. Designed for neurodivergent adults. Private events: Must also join the Meetup group, fill out the Jotform, and have prior approval.
  • What types of social activities are you most interested in?
  • Do you prefer in-person events, online events, or both?
  • Which days of the week are you generally available for social events?
  • What is your preferred event duration?
  • What group size do you feel most comfortable in?
  • What do you hope to gain from attending Adult Socials?
  • How often do you currently socialize with peers outside of work or family?
  • Do you feel there are enough safe, neurodivergent-friendly social spaces in San Antonio?

  • Neurospicy Volunteering

    Complete ALL QUESTIONS this section ONLY if you selected Neurospicy Volunteering above. Otherwise, skip to the next section. Program Description: Neurospicy SA's Neurospicy Volunteering empowers neurodivergent adults through structured group volunteering. Participants develop workplace skills, build confidence, and discover their strengths in a supportive environment. Schedule: Flexible | Locations: Various San Antonio sites | Format: Small to medium groups.
  • Which volunteering roles interest you?
  • Preferred group size
  • Which days are you generally available?
  • Rows
  • Preferred session length
  • Rows
  • What do you hope to gain from volunteering?
  • Have you volunteered in any capacity in the past year?

  • ND Navigation: Coaching

    Complete ALL QUESTIONS this section ONLY if you selected “ND Navigation: Coaching” above. Otherwise, click Next to skip. Program Description: One-on-one support for neurodivergent individuals seeking to build systems, break through stuck patterns, and reclaim agency over their lives. Sessions: 45 min (+ 15 min buffer) | Times: 6pm–7pm | Days: Mon–Thu | Format: Virtual via Google Meet. Coaches | Julian Jackson & Adam Fields
  • Which coach(es) are you interested in seeing?
  • How did you hear about this program?
  • What areas are you hoping coaching will help you improve?
  • How often do you feel overwhelmed managing day-to-day tasks?
  • How important is confidentiality to you in a coaching setting?

  • Neurospicy Networking

    Complete ALL QUESTIONS this section ONLY if you selected Neurospicy Networking above. Otherwise, skip to the next section. Program Description: Free events providing safe, professional spaces for neurodivergent adults and neurodivergent-supportive organizations to meet and build meaningful relationships. Time: 6pm-8pm | Schedule: 1 Thursday per month | Location: I Love Churros Restaurant, 7007 Bandera Rd Unit 14, San Antonio, TX 78238 | Co-hosts: Julian Jackson & Eligio Alavez (Eli).
  • Are you representing an organization that supports, hires, or works with the neurodivergent community?
  • How did you hear about these events?
  • What do you hope to get out of attending?
  • Do you feel there are enough professional spaces designed for neurodivergent adults in San Antonio?

  • Common Ground: Peer Group

    Complete ALL QUESTIONS this section ONLY if you selected Common Ground: Peer Group above. Otherwise, skip to the next section. Program Description: A free, peer-led support group for neurodivergent adults who have experienced mental health challenges. A safe, non-judgmental environment where your voice is heard. Time: 6pm-7:30pm | Schedule: Saturdays | Location: Bihl Haus Arts (2803 Fredericksburg Rd, San Antonio, TX 78201) | Facilitator: Teenya Creswell.
  • How did you hear about this program?
  • What do you hope to feel or experience after attending?
  • Have you ever participated in a peer support group before?

  • Community Agreement and Code of Conduct

    The following rules apply at every Neurospicy SA program and event — in person and online. Check each box to confirm your agreement.

  • Membership and Event Participation

  • Neurospicy SA is a peer community organization and does not provide licensed mental health, medical, legal, or clinical services. My participation is entirely voluntary. To the fullest extent permitted by Texas law, I release Neurospicy SA and its officers, directors, board members, volunteers, and staff from any and all liability for injury, loss, damage, or claims arising from my participation in any current or future Neurospicy SA program or event.
  • Photo and Video Consent
    Neurospicy SA may photograph or video-record events for organizational use. You may withdraw consent at any time by notifying info@neurospicysa.org.
  • Please select one:*

  • Final Confirmations

  • Digital Signature
    By typing your full legal name below you are providing your digital signature. You confirm that you have read, understood, and agreed to every section of this form — including the Member Participation Agreement, Code of Conduct, and Standing Event Waiver. This agreement is governed by the laws of the State of Texas and is valid for all Neurospicy SA programs and events from this date forward. Questions? Contact info@neurospicysa.org
  • Date Signed*
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  • Should be Empty: