Day Support

Day Support Programs

Karen O’Rourke – Deputy Director of Services, korourke@arcpva.org

 

Charlottesville Day Support Center – (434) 977-4002

Doug Desper – Charlottesville Day Support Manager, ddesper@arcpva.org

1149 Rose Hill Drive Charlottesville, VA 22903

 

Nelson Day Support Center – (434) 989-8964

Lois Giles – Nelson Day Support Manager, lgiles@arcpva.org

American Legion Building, 22 Nelson Highway, Shipman VA 22971

 

Louisa Day Support Center – (540) 967-4437

korourke@arcpva.org

522 Industrial Drive, Louisa VA 23093

 

Please fill out our application for services below.

Application for Services

  • APPLICATION: COMMUNITY SUPPORT SERVICES

  • Personal Information

  • Date Format: MM slash DD slash YYYY
  • GUIDELINES

  • Emergency Contact Person

  • Emergency Orders
  • SOCIAL & DEVLOPMENTAL SUMMARY

  • FAMILY SUMMARY

  • home
  • Work/cell
  • home
  • Work/ Cell
  • MEDICAL HISTORY

  • Indicate if the Applicant has any of the following illnesses, and/or chronic conditions

  • MEDICATION PROFILE

  • NameDosageTimes TakenReasonSide Effects 
    Click + on right to add more
  • SUPPORT

  • HISTORY OF RESIDENTIAL TREATMENT OR INSTITUTIONALIZATION:

  • Name of Agency or InstitutionAddressDates (to/from) 
    Click + on right to add more
  • Agency/ ProfessionalDates (to/from)Contact Person/ Case Manager 
  • Date Format: MM slash DD slash YYYY
  • FOR OFFICE USE ONLY

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY