STEP 1 - Getting Plan Ready
Participant 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 – Monitoring
STEP 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. /
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 child
This 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 providers.
Where I live and the people I live with
What 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 me
Who 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 life
What 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)?
· 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.
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.
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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:
______
______
______
______
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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:
______
______
______
______
/
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 /Morning
1am – NOON
Afternoon
NOON – 6pm
Night
6pm - Midnight
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Sometimes I do (my child does)…..…..List activities such as holidays that your child does sometimes /
Notes:
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
Services and community groups
These 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
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
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