STEP 1 - Getting Plan ReadyParticipant Statement Workbook

This Participant Statement workbook is to help you with STEP 1 – Getting Plan Ready.

It includes activities to help you to think about your (or your child’s) needs and goals now and in the future. The next steps in the planning process are:

STEP 2 – having your Planning Conversation with the National Disability Insurance Agency (NDIA), the time this takes can be different for each participant

STEP 3 – Plan Implementation STEP 4 – MonitoringSTEP 5 – Plan Review

Completing the Participant Statement helps the National Disability Insurance Agency (NDIA – the agency) with the information we need to complete your (or your child’s) NDIS plan with you including:

your (or your child’s) situation what you (or your child) would like

to achieve

Please fill in this workbook and give it to the agency before your first planning conversation. There are Plan Readiness workshops that you can attend to help you. You can also bring any other information that would help the planning conversation.

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Full Name (and preferred name)      

NDIS Number      

How much help did you need to complete this workbook? ☐No help ☐Some help ☒Complete help

If you had help completing this workbook on please tell us:Name of people who helped fill in this workbook      

Relationship to the participant (Example: Mother, Father, Guardian, Nominee, Friend, Advocate, Community Connector)

     

Part 1: About me / my childThis part of my (or my child’s) Participant Statement is about me (or my child), my (or my child’s) life, and the people in my (or my child’s life). I understand that this will be included on my (or my child’s) NDIS Plan and if I consent will be able to be seen by my registered

2

My (or My Child’s) Participant StatementThis information will help the agency to learn about me (or my child) and support the

conversations they will have with me to develop my (or my child’s) NDIS Plan.

providers.

Where I live and the people I live withWhat are your (or your child’s) current living arrangements? Example:

Who do you (or your child) usually live with? What sort of home do you (or your child) live in?

     

People in my life who support meWho are the important people in your (or your child’s) life and how do they help you? Example:

Family and friends, doctors, teachers, carers or others you (or your child) see often (you might have included some of these people on your Access Request Form)

Any other people who play an important role in your child’s life

My daily lifeWhat happens in your (or your child’s) day to day life for social and work related activities? Example:

What do you (or your child) do regularly during the day (education, school, sport, social activities, volunteering and work)?

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TIP: It is a good idea to be clear who is answering the questions. Example: I live with my Mum (Sarah) and Dad (Simon)…. OR; Matthew lives with us, his Mum (Sarah) and Dad (Simon)….

What things are working well? What are the things you (or your child) enjoy? What are the things you (or your child) are good at? What would you (or your child) like to change?

Part 2: My Goals This part of my Participant Statement lists my (or my child’s) goals and things I want to work towards during this plan.

Think about your (or your child’s) goals, big (Life Goals that might take longer to work towards) or small (goals that could be worked towards in a short time during the Plan). Imagine how your (or your child’s) life could be and what supports you (or your child) might need to work towards and achieve those goals.

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TIP: You can use the calendar on page 8 to help you

Goals to be independent and do ordinary day to day things

Doing more things for yourself/themselves Learn new life skills and become more independent What is it you (or your child) want to change or achieve? Are there things in your daily life you (or your child) would like to

maintain or keep the same?

Goals about doing things in your community

Spending more time with other people in your community Making more friends or spending more time with family Trying new activities, like joining a club or group Being more able to attend events

Goals around building relationships with family and friends

Are you (or your child) happy with the relationships in your (their) life?

Are you (or your child) having difficulty in social situations or with Relationships

Social and community

participation

Daily Living

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Goals for improving or maintaining health and wellbeing

Do you (or your child) want to get healthier, change your diet or do more physical activity, like taking up a sport?

What is it you (or your child) want to change or achieve?

Goals for learning something new or improving skills

Are you happy with the control that you (or your child) have over the choices you (they) make in daily life?

Do you (or your child) need help to make choices about who supports you and when?

Goals for learning something new or improving skills

Like a new skill or qualification? Are you (or your child) starting or moving to a new school or other form of

education? What do you (or your child) want to achieve?

Goals around building relationships with family and friends

Are you (or your child) happy with the relationships in your (their) life?

Are you (or your child) having difficulty in social situations or with

Goals for finding, getting and keeping a job (paid or volunteer)

Do you (or your child if nearly 15 or over 15 years of age) want to get a job or volunteer?

Do you want to increase your work or volunteer hours? Does anything need to happen before you (or your child) are job ready? Do you (or your child) need anything to keep you being able to work?

Work

Choice and

Control

Health and wellbeing

Learning

GOAL EXAMPLE: My first (1st) goal is: To ride a bike by myself without anyone pushing me along

During this plan I want to: build my strength in my legs During this plan I want to: be able to go for a bike ride with my sisters, mum and dad.

Add your goals below. The agency encourages you to have at least one goal and at least one thing you want to do during this plan. Having too many goals makes it harder to keep focus and achieve them.

Think about the things you (or your child) want to change or do now or in the next few years. Think about what or who (informal, community, mainstream or disability and developmental delay supports could help to achieve this goal (see pages 10 – 12 for examples).

My first goal is:       _______________

During this plan I want to:       _________________________________

During this plan I want to:       _________________________________

The informal, community and mainstream support I can use to help me are:      _________________________________

      _________________________________

      _________________________________

      _________________________________

My second goal is:       _______________

During this plan I want to:       _________________________________

During this plan I want to:       _________________________________

The informal, community and mainstream support I can use to help me are:      _________________________________

      _________________________________

      _________________________________

      _________________________________

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My third goal is:       _______________

During this plan I want to:       _________________________________

During this plan I want to:       _________________________________

The informal, community and mainstream support I can use to help me are:      _________________________________

      _________________________________

      _________________________________

      _________________________________

My fourth goal is:       _______________

During this plan I want to:       _________________________________

During this plan I want to:       _________________________________

The informal, community and mainstream support I can use to help me are:      _________________________________

      _________________________________

      _________________________________

      _________________________________

My fifth goal is:       _______________

During this plan I want to:       _________________________________

During this plan I want to:       _________________________________

The informal, community and mainstream support I can use to help me are:      _________________________________

      _________________________________

      _________________________________

      _________________________________

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My (my child’s) activities calendar Completing this calendar can help you to complete your (your child's) NDIS Participant Statement. Think about activities that you do (or your child does) regularly, for example, attending school/ pre-school or child care, family activities, social activities with friends, sports, music and dancing and any therapy, appointments for services (including speech pathology, OT and physio). The next page has space to add activities or regular events and notes.

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Mor

ning

1am

– N

OO

N

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Afte

rnoo

nN

OO

N –

6pm      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Nig

ht6p

m -

Mid

nigh

t

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

8

Sometimes I do (my child does)…..…..List activities such as holidays that your child does sometimes

     

     

     

     

     

     

Notes:     

     

     

     

     

     

     

     

     

     

     

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Part 3: My Supports These are the supports that will help me to work toward my goals, you might have already listed some when you were thinking about your goals. Now you can bring them all together and see if there is any missing?

Family and friends This is what the NDIS call ‘informal’ supports.

Who will provide the support? Type of support

Example: Mum and Dad Example: help me learn to ride my bike and take me on bike rides on weekends

           

           

           

           

           

           

           

           

           

10

Tell us about the informal supports you (or your child) have that you think could help to achieve the goals and things you want your child to do during this plan.

(E.g. parents, friends, siblings, grandparents)

Services and community groupsThese supports might include things like health or mental health services, schools or education services, community groups, sporting or hobby clubs or other government services. This is what the NDIS call ‘mainstream and community’ supports.

Who will provide the support? Type of support

Example: School Example: Let me ride my bike at school bike education class

           

           

           

           

           

           

           

           

           

           

           

11

Tell us about the community and mainstream supports your child has now and the ones that you think could help to achieve the goals and things you want your child to do during this plan to work towards those goals.

(E.g. schools, pre-schools, sporting and social clubs, and community groups)

Anything else Anything else you would like us to know about your child’s needs including the areas they need support or have difficulties with, due to their developmental delay or disability.

Type of support

Example: Occupational Therapy to help build muscle strength in legs to push bike pedals

Example: Modifications to bike so that can pedal independently

     

     

     

     

     

     

     

12

Tell us about the Developmental Delay or Disability supports your child has now to help with their needs and the ones that you think could help to achieve the goals and things you want your child to do during this plan to work towards those goals.

(E.g. therapy, mobility assistance, communication assistance, equipment, self-care, home and vehicle modifications))