Individual File
NB: this 'Individual File' page is predominantly for Samaritans staff use.
Feedback Form: Individual File
Individual File Contents Page version 2.2
Section One: Information and Support Profile
Individual File Section One
1-0 Location of Additional Documents
1-0-1 Document Review Sign Sheet
1-1 Signature Page
1.2 Consent to Exchange Information ver 2.1 1-2-1 Consent to Share Information-Carer 1.2.2 Consent to Exchange Information RESPITE ver 2.1
1-3 Information and Birth Certificate
1-3-1 Service Provider Details
1-4 Support Profile
1-4-1 Risk Profile
1-4-1 Risk Profile-High 1-4-1 Risk Profile-Low 1-4-1 Risk Profile-Medium 1-4-1 Risk Profile-No Colour
1-4-2 Risk Assessment-Service User
1-4-3 Risk Assessment-Home Unsupervised
1-5 Progress Note
1-5-1 Case Note 1-5-1 Case Note EMAIL
1-6 Profile Note
1-6-1 Services and Placement History
1-7 Weekly Routine
1-7-1 Daily Routine
1-8 Outing and Holidays Register
1-9 Family and Friends Register
1-9-1 Family and Friends Contact
1-10 Personal Care Support Plan
1-11 Transportation Support Plan
1-12 Mobility Support Plan
1-12-1 Falls Record
1-13 Active Support Plan (Under Construction)
1-14-1 Communication Assessment (Under Construction)
1-14-2 Communication Support Plan (Under Construction)
Behaviour Support Documentation
Visit the CSU pages on the staff intranet for Behaviour Support documentation including Behaviour Support Plan templates, behaviour assessment tools, Pathogenesis Mapping exercises, data collection management and analysis tools, Restricted Practice protocols and monitoring documentation, and much more.
1-15-1 IPRP
1-15-2 Interaction Guidelines
1-15-3 Scatter Plot
1-15-3 ABC Chart
1-15-4 Insert Behaviour Assessments/Support Plans from other providers here
1-15-5 Restricted Practices Authorisation/Submission - Visit the CSU page on the staff intranet for a Restricted Practices Submission form, or a CSU Service Request Form. They are updated regularly, and you must submit your requests on the latest version of the form!
1-16 Support Plans OTHER Insert
1-17 Guardianship Orders Insert
Section Two: Health and Medical
Individual File Section Two
2-0 Medical Profile
2-1 Medical Notes
2-2 Medical Appointment Diary
2.2A Annual Health Checks Record
2.2B Health and Medical Review Inserts
2.2.1 Medical Appointment Checklist
2-3 Person Responsible Nomination-Medical and Dental 2-3 Person Responsible Nomination-Medical and Dental PDF
2-4 Health Support Plan
2-5 Medical Report and Correspondence Inventory
2-6-1 Weight Record
2-6-2 Weight Chart
2-7 Health Support Plans OTHER Insert
2-8 Eating and Drinking Support Plan
2-8-2 Food and Drink Diary
2-8-3 Weekly Food and Drink Diary or plan
2-8-4 Daily Food and Drink Diary or Plan
2-8-5 Nutrition and Swallowing Risk Checklist - file insert
2-8-5 Nutrition & Swallowing Risk Checklist - form
2-8-6 Nutrition and Swallowing Risk Checklist SUMMARY
2-9 Epilepsy Support Plan
2-9 Epilepsy Support Plan TABLE
2-9-1 Emergency Epilepsy Plan
2-9-2 EMERGENCY MEDICATION
2-9-2 EMERGENCY MIDAZOLAM
2-9-3 Seizure Record
2-9-4 Seizure Chart
2-9-5 Seizure Report
2-10 Oral Care Plan
2-11 Toilet Record
2-11-1 Bowel Chart
2-11-2 Bowel Record
2-12-1 Sleep Chart 24 hour WEEKLY
2-12-2 Sleep Chart 16 hour WEEKLY
2-12-3 Sleep Chart 24 hour MONTHLY
2-12-4 Sleep Chart 16 hour MONTHLY
2-13 Menstruation Chart
2-14 Physical Activity Plan
2-14-1 Physical Activity checklist
2-14-2 Physical Activity Record
2-14-3 Physical Activity Chart
2-16-1 Medical Correspondence INCOMING
2-16-2 Medical Correspondence OUTGOING
2-17 Health and Medical information INSERT
Section Three: Individual Planning
Individual File SectionThree
3-1 Case Plan
3-1 Individual Plan
3-1 Transition Plan
3-2 IP Activity Note
3-3 Program Instruction Sheet
3-4 Task Analysis
3-5 IP Participation Log
3-6 IP Meeting Minutes
3.7 Individual Plan Annual Review
3.8 Key Worker Report Instructions
3.8.1 Key Worker Checklist monthly
3-8-2 Quality of Life Report ver 3
3.8.3 Documentation Checklist
3-8-4 IP Quarterly Review
3-8-5 IP service Supervisor Checklist
3-9 Consent to Exchange Information-individual planning
Section Four: Financial and Correspondence
Individual File Section Four
4-1 Inventory of Personal Belongings 4-2 Financial Account Details 4-3 Income, Entiltements and Subsidies 4-5 Correspondence Inventory
4.5.1 Correspondance IN
4.5.2 Correspondance OUT
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