A LITTLE SPACE FOR YOUR THOUGHTS

My support preferences

Explain what helps, what matters and how you want to be involved. Complete any sections that help, then print or save your copy.

To type into a worksheet, enable JavaScript in your browser. You can also download the blank PDF and complete it on paper.

Your answers stay in this tab. They are not sent to Elevate or saved on this website. Print or save before leaving or refreshing. On a shared device, clear the sheet when you are finished.

All fields are optional. Use your own words. You do not need to enter identifying or health information to use this tool.

What I would like you to know about me

Interests, strengths and things that matter to you.

Up to 1,800 characters

How I like to communicate

Words, writing, pictures, a device, an interpreter or another approach.

Up to 1,800 characters

What helps me make choices

How you want options explained, time to think and who you want involved.

Up to 1,800 characters

What good support looks like for me

What you want to do yourself and where you would like help.

Up to 1,800 characters

Things to ask me before doing

Your boundaries, privacy, routines and preferences.

Up to 1,800 characters

Who I choose to share this with, and when to review it

You can update your preferences. Check the copy still reflects what you want.

Up to 1,800 characters

Blank PDF

In the print window, choose a printer or “Save as PDF”. On some phones, saving is available under Share. Only the worksheet is printed.

YOUR WORKSHEET PREVIEW

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