Your life. Your plan.
Getting ready for a CHC Checklist
Use the prompts that are helpful to you. You can write, draw, or ask someone to record your own words.
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Choose who you share your completed copy with. On a shared device, clear your answers when you finish.
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My meeting
Record the date, location, worker’s name and how to contact them.
What helps me take part
Describe communication, sensory or access needs, breaks and who you want involved.
An example of my care
Record the date, need, time of day and what happened. Use another copy for another example.
Help and skills needed
What did another person do? Include prompting, supervision, physical help, skilled care and monitoring.
How often and how long
Record frequency, duration, night care and whether this was a usual or unusual day.
What keeps me well
Record ongoing support that prevents difficulties. Do not remove support to test what happens.
Missing help or changing needs
Explain help needed but unavailable, or differences between better and worse days.
Useful records and people
List relevant reports or care records and people who know your needs. Share these through the agreed secure route.
My views and corrections
What matters to you? What is missing or inaccurate in the written account?
Outcome and next action
Record the result, reasons, referral date, coordinator, next contact and any request for reconsideration.