Community participation (attending pre-school, school, child care, family and social activities, participating in sport, recreation and leisure activities) If the child you provide care for has a condition that changes from day to day or week to week, please indicate the level of help you provide on most days or weeks. If someone other than you (e.g. NDIS, home care or other service provider) helps with community participation, do not include this care. Please tick one box in each row that best describes the help you provide to this child because of their disability or medical condition. Level of help I No help Some help A lot of help Complete provide help I do not have I have to give I have to give to help at all some prompts, a lot of I have to reminders or physical help give total or not supervision or continual help relevant to prompts and my With these activities guidance circumstances Participating at pre-school, school or childcare e.g. joining in activities, fitting in with school routines Social activities in community settings Participating in sports, recreation and leisure activities Time away from you In most weeks how many hours has the child you care for been away from you at any of the following activities? (If the child is away from you part of one week every fortnight include half the time.) Away from you at Hours per week Pre-school/school/day-care Other education Day program/activity Work Respite Cared for by someone else Other Information Are there any other types of care you provide to this child that have not been covered in this claim process? No Go to next question Yes Give details below Carer’s Declaration In the version of this form there would be a declaration for you to sign that the information you have provided is
Community participation (attending pre-school, school, child care, family and social activities, participating in sport, recreation and leisure activities) If the child you provide care for has a condition that changes from day to day or week to week, please indicate the level of help you provide on most days or weeks. If someone other than you (e.g. NDIS, home care or other service provider) helps with community participation, do not include this care. Please tick one box in each row that best describes the help you provide to this child because of their disability or medical condition. Level of help I provide With these activities No help I do not have to help at all or not relevant to my circumstances Some help I have to give some prompts, reminders or supervision A lot of help I have to give a lot of physical help or continual prompts and guidance Complete help I have to give total help Participating at pre-school, school or childcare e.g. joining in activities, fitting in with school routines Social activities in community settings Participating in sports, recreation and leisure activities Time away from you In most weeks how many hours has the child you care for been away from you at any of the following activities? (If the child is away from you part of one week every fortnight include half the time.) Away from you at Hours per week Pre-school/school/day-care Other education Day program/activity Work Respite Cared for by someone else Other Information Are there any other types of care you provide to this child that have not been covered in this claim process? No Go to next question Yes Give details below Carer’s Declaration In the version of this form there would be a declaration for you to sign that the information you have provided is