ADHD Autism Spectrum Anxiety Depression OCD PTSD Bipolar Intellectual disability Learning disability Speech or language disorder Sensory processing differences Tourette Epilepsy or seizure disorder Traumatic brain injury Other neurodevelopmental condition Prefer not to say

Speaks verbally Uses AAC device Uses gestures Uses writing Prefers simple sentences Needs extra processing time Prefers quiet environment Avoid touching Contact caregiver first

Loud noise Bright lights Crowds Touch Strong smells Sudden changes Physical restraint Sirens Confined spaces Unknown

Speak slowly Offer water Quiet room Dim lights Allow space Deep breathing guidance Contact caregiver Familiar object Music or earphones Avoid touching

Diabetes Hypertension Heart disease Asthma COPD Epilepsy or seizure disorder Kidney disease Liver disease Cancer Severe allergies Blood thinner use Hearing impairment Vision impairment Mobility impairment Other

Dementia Alzheimer's disease Mild cognitive impairment Parkinson's disease Stroke history Delirium episodes Memory loss No diagnosis Prefer not to say

Uses wheelchair Uses walker Uses cane Limited balance Needs assistance walking High fall risk Bedbound None

Hearing aids Glasses Walker Cane Wheelchair CPAP Oxygen Pacemaker Medical alert bracelet Other

Diabetes Hypertension Heart disease Asthma COPD Epilepsy or seizure disorder Kidney disease Liver disease Cancer Severe allergies Blood thinner use Hearing impairment Vision impairment Mobility impairment Other