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Professional Information Sharing Form

  1. Hanover County Parks and Recreation

  2. Professional Information Sharing Form

    Dear Teacher:
    The family of this child has requested the assistance of a Therapeutic Recreation Aide during Parks and Recreation day camp programs.
    To help us allow the child to have the most successful experience possible, we’d like to learn a bit about what works best for the child in the classroom setting.
    Thanks for your help in completing this form.

  3. Please check all appropriate statements that best describe the characteristics of the above participant:

  4. Participation Style

  5. Information Processing

  6. Independence

  7. Relationship to Authority

  8. Group Skills

  9. Environment for Participation

  10. Ability to Follow Directions

  11. Attention/Processing

  12. Interfering Behaviors

  13. If you have any additional information that would be helpful as we work to develop an Inclusion Plan for this child, please feel free to contact Hanover County Parks and Recreation at 804-365-7150 or via email at [email protected] Thank you for your assistance!

  14. Leave This Blank:

  15. This field is not part of the form submission.