FORM NEURODIVERGENT | JMJ Insulation

NEURODIVERGENT ZONE

Primarily, we want you to feel comfortable with us, any information provided will be shared only with the team members conducting and overseeing works at your residence.

Sustainable strategy approach to eliminate waste and pollution for future growth of busine

You can tell us whatever you want or nothing at all! It is entirely up to you. Please have a look at the example below and fill in the boxes. Our full privacy policy is available on this website.

Would you like to tell us about your (or other resident's) NEUROTYPE, LIFELIONG CONDITION or DISABILITY?

e.g., specific support needs e.g., ASC, ADHD, OCD

Would you like to tell us about how your NEUROTYPE, LIFELONG CONDITION or DISABILITY affects you (or another resident)? Please include as much or as little information as you wish.

e.g., I do not like to talk - will not engage in small talk.

e.g., I suffer from anxiety.

e.g., Noise really bothers me.

e.g., I am very curious - will ask a lot of questions.

e.g., I will not talk - do not ask me questions.

Would you like to tell us about accommodations you use?

e.g., I will wear noise cancelling headphones during your visit.

e.g., I will play loud music.

Would you like to tell us about accommodations we could implement for you during the period of works?

e.g., wear PPE including face mask if interacting with me.

e.g., do not ploy any music in your area of work.

Is there anything else you would like to share with us that could help to make you feel more comfortable with us during our visit?

e.g., Eye contact makes me uncomfortable.

e.g., I might start stimming if I am excited or overwhelmed:

·Rocking

·Flapping hands, flicking, or snapping fingers.

·Bouncing, jumping, or twirling

·Pacing or walking on tiptoes.

·Repeating words or phrases

Your name

Preferred pronoun

Phone

Address (please enter the address where the works will be taking place)

Scheduled date for start of the works

Day

Month

Year

What is your preferred method of communication?

Would you like to share anything else?

EVERYTHING STARTS WITH TRUST

NEURODIVERGENT ZONE

COMMITTED TO EXCELLENCE