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Child’s Personalized Swimming Portfolio – Intake Form

What This Intake Form Covers

Child Basics & History

Name, age, diagnosis, and past lessons (what worked or didn’t).

Sensory & Behavior

Comfort levels with sound, light, and touch, plus calming strategies.

Communication & Learning

How your child communicates, prefers to learn, and what motivates them.

Interests & Movement

Favorite activities, strengths, and motor skills in and out of the water.

Emotions & Safety

Water comfort, anxiety levels, and any specific medical or safety concerns.

Parent Goals & Vision

Your personal goals and the specific pool setup that works best.

Format & Support

Options for “friend-instructors” and our collaborative video recording format.

Fees & Funding

Sliding-scale rates and funding options (e.g., BC Autism Funding).

You can share as much detail as you’re comfortable with. Your answers help us build a safe, personalized swim plan.

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