Building community • Sharing resources • Promoting acceptance
nckdssbuddywalk@yahoo.com
Welcome To NCKDSS

Let’s get your family started with NCKDSS

This new member questionnaire helps us learn more about your family, connect you with local support, and include you in the programs and events that matter most.

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Family Information Health Snapshot Community Connection

Why this matters

Your questionnaire helps NCKDSS understand the families we serve, invite you to opportunities that fit your needs, and build stronger support across our region.

NCKDSS stars together at an event
Every new member story matters, and we are excited to welcome your family into the NCKDSS community.
Before you begin

This questionnaire helps us welcome your family, understand your needs, and connect you with the right opportunities.

Membership and connection We’ll collect the names, dates, and family details that help us know who we’re serving.
Events and outreach Contact information and location help us connect you with resources and local opportunities.
Updates later are okay Buddy Walk participation and comments help us welcome you in a more personal way.
New Member Questionnaire
Complete this form to help us welcome your family and keep our records up to date.
Before you begin
This information helps NCKDSS welcome your family, understand your needs, and connect you with events and resources.
Parents and caregivers
Siblings
Contact information
Primary address
Alternate address
Medical and screening snapshot
Answer any items you know now. It is okay to skip or choose “Prefer Not to Answer.”