(Toys, Music, Objects, Topics, Etc.)
If non-verbal: Sign language, picture boards, written words, etc
If verbal: Preferred words, sounds, songs, phrases
Does the individual carry an identification card, wear jewelry tags, medical alert bracelet, etc? If so, list above.
Does the individual have a Project Lifesaver or Lojack SafetyNet transmitter number?
Would you like to receive a decal to display on your residence window or door, to alert North Miami officers that someone in the home has Autism?
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
This field is not part of the form submission.
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