Participant Intake Form

This 4-page comprehensive client intake form is designed to gather essential information about an individual with a disability and their specific care needs to enable providers and sole traders to write up a care plan, service agreement, and provide high-quality person-centred care. It includes sections such as:

• Client and care person contact details
• Emergency contact
• Funding Type
• Support coordination and plan management contacts
• Relevant cultural information
• Diagnoses & other relevant medical details
• Communication preferences 
• Therapies and Behaviour plans
• Medications
• Type of supports (community access, transport, high intensity, personal care)
• Support hours needed
• Large additional notes section

The form serves as a vital tool for service providers, caregivers, and support professionals to ensure they share a thorough understanding of the client's needs and can tailor their support services accordingly. By collecting detailed information upfront, service providers and sole traders can streamline the intake process, better allocate resources, and ensure that the client receives the most appropriate and effective care possible.

Disclaimer: Users of these documents should consult with a qualified legal advisor to ensure that any information contained herein is applicable to their specific circumstances and is in compliance with relevant laws and regulations. The author and distributor of this document make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability with respect to the information contained within. Any reliance you place on such information is strictly at your own risk.