Your first name (required)
Your last name (required)
Your email (required)
Do you have any dietary preferences? (required)
nonevegetarianveganother (pls explain in the comments below)
What questions bring you to The Arc? (required)
Please note that you do NOT have to answer the following questions.
We ask this as part of our standard procedure. Do by no means feel bad about answering yes. The only thing that might happen is that a team member contacts you prior to The Arc.
Leave the box blank if your answer is no.
Within the last 5 years did you experience any of the following: Depressions or heavy depressive moods, epileptic seizures, borderline syndrome, schizophrenia, or any other mental disorder, and/or did you go through psychological treatment?
Within the last 5 years did you take any mood affecting medication?
Are there any other safety/health issues facilitators should be aware of?