MY MOORABOOL SHIRE COUNCIL CARE PLAN My name Date Care Plan Developed: Date for Review If you cannot get in contact with me the plan is… SERVICES WE HAVE AGREED TO DELIVER What do you want to Tasks that my Tasks that I can do Frequency/Duration of Date service will Review progress achieve by working Community will include service commence date together? Support Worker will do to assist me. Acknowledgement: understand and agree to this care plan and to copies being provided to the Community Support Worker” “I Signature of client or carer or legal representative: Date:
MY MOORABOOL SHIRE COUNCIL CARE PLAN My name Date Care Plan Developed: Date for Review If you cannot get in contact with me the plan is… SERVICES WE HAVE AGREED TO DELIVER What do you want to achieve by working together? Tasks that my Community Support Worker will do to assist me. Tasks that I can do will include Frequency/Duration of service Date service will commence Review progress date Acknowledgement: “I understand and agree to this care plan and to copies being provided to the Community Support Worker” Signature of client or carer or legal representative: Date:
client%20care%20plan_0.docx