Date, Time, Location

Set a date

Set a start time

Set a end time

I would like John to be dropped off

Who will be present?

Jamie

Steven

Peter

I would rather not say

What will it be for?

This will help ensure John is adequately dressed & prepared for the day

General Chat

Birthday (or other) Party

Funeral or Wedding

I would rather not say

Medication

There may be times you need to administer certain pills, drugs or injections as prescribed by medical professionals for Johns well-being.

Tick this box if John will be with you for more than 6 hours

Tick this box if there will be moderate walking involved

Tick this box if you are NOT comfortable administering such medication *

* If ticked, we will make a best effort to approve your request if medications are simple and not health critical, but if there are more advanced, critical medications or strict time schedules that happen to co-inside with your time with John, we will deny the request for you and look to re-schedule. Thank you for your honesty.

Additional Requirements

Your Name

First name or both

Your Email

Where should we send notifications to?

I agree to be mutually civil and respectful to all parties involved during pickup and dropoff.

I agree to provide John with any required medication as instructed during pickup for the sake of Johns health and well-being

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