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911 FUNCTIONAL NEEDS INDICATOR REQUEST FORM (Please PRINT)Telephone Number Voice TTY Name of Requestor Name & Age of Person with Functional Needs Address City/Zip Code By submitting this completed

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How to fill out special and functional needs

01

To fill out special and functional needs, follow these steps:

02

Identify the specific special and functional needs of the individual or group you are addressing.

03

Create a comprehensive assessment plan to gather relevant information and gather data on the needs.

04

Use appropriate assessment tools and techniques to evaluate the special and functional needs.

05

Develop an individualized plan or program to meet the identified needs.

06

Implement the plan or program, providing necessary support and accommodations.

07

Regularly monitor and reassess the progress of the individual or group.

08

Make necessary adjustments to the plan or program based on observed outcomes and new information.

09

Continuously communicate and collaborate with the individual or group, as well as their support network, to ensure their needs are being met effectively.

10

Evaluate the overall effectiveness of the interventions and make further modifications if needed.

11

Maintain ongoing documentation and records to track the progress and outcomes of the special and functional needs.

Who needs special and functional needs?

01

Special and functional needs are required by individuals or groups who have specific challenges or limitations that affect their ability to function, participate, or access resources in the same way as others.

02

Some examples of individuals who may need special and functional needs include:

03

- People with disabilities, such as physical, sensory, cognitive, or developmental disabilities.

04

- Individuals with chronic health conditions or terminal illnesses.

05

- Elderly individuals who require assistance with daily activities and mobility.

06

- Children with learning disabilities or special educational needs.

07

- Individuals recovering from an injury or undergoing rehabilitation.

08

- Individuals with mental health disorders or psychological conditions.

09

- People living in poverty or facing socioeconomic challenges.

10

It's important to remember that special and functional needs can vary greatly among individuals, and each person's needs should be evaluated on an individual basis.

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