Follow the steps to effectively complete the application form.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date at the top of the form in the designated space.
3. Provide the information for PARENT/GUARDIAN INFORMATION #1. Fill in the full name, relationship (parent or guardian), home address, home phone number, mobile phone number, email address, office phone number, and complete the fields corresponding to PARENT/GUARDIAN INFORMATION #2 in the same manner.
4. In the CHILD’S INFORMATION section, include the child's name, date of birth, height, weight, and birth order. Indicate the school name and type, along with the street address, city/state/zip, office phone, and county.
5. Under HEALTH INFORMATION, fill in the doctor’s name, office name, complete address, office phone, and fax number. List the primary and secondary diagnoses, along with the ages at the time of diagnosis.
6. Specify with whom the child currently lives and detail the number of hours per week the child is in school or therapies. List the types of therapies the child is currently involved in, along with a description of significant symptoms and their effects on the child. Attach additional information if necessary.
7. Detail the medications the child is taking, including dosages and frequency, and specify the type of residence they currently reside in.
8. Provide information about other children in the home by filling in their names, sex, and date of birth.
9. Indicate whether your residence has a fenced yard or enclosed area, and specify if there are any pets in the household or any members of the household who are allergic to dogs or pet dander.
10. Indicate whether anyone in the home has previously owned a service dog or assistance dog.
11. Once all fields are completed accurately, review the form for correctness and clarity. You can then save changes, download a copy, print, or share the form as necessary.

Complete your documents online today for Bruster's Buddies For Autism.