Information
New Customer Interview
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Customers Name
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Customers Photograph
Service Delivery, Clinical Support, and Corporate Services Pre-entry information
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Profile Commenced on
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Profile Completed by
Client Details
Client Details
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Open Client Details
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Client Personal details have been completed in Supportability
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Mandatory Fields Include:-
Full Name
Full Street Address (Postal only if Different)
Phone - Mobile or Home or Both
Email
DOB
Gender
Language
Country of Birth
ATSI Origin -
Client Living & Transport Details have been completed in Supportability
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Client Guardian Details have been completed in Supportability
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Contact details must be completed in the Contact section before these can be added from the drop down box
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Section Completed
Privacy Settings
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Open Privacy Settings
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Privacy Settings have been completed in Supportability
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Section Completed
Client Service Participation
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Open Client Participation
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Information has been entered into Supportability
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Site or Sites Added
Services Added
Start Date Entered
Key Worker Identified -
Section Completed
Consent
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Open Consent
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Information has been entered into Supportability
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Consent Status Completed
Consent Exclusions Completed
Media Consent Form
Medical Consent Form
Therapy Consent Form -
Consent Documentation has been uploaded to Supportability
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Section Completed
Administration Details
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Open Administration Details
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Information has been entered into Supportability
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Region
LGA
Client Start Date Completed -
Section Completed
External Services
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Open External Services
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Are there other External Support Services
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Information has been entered into Supportability
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Provider Identified
Location
Days of Week -
Section Completed
Status
Warnings
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Open Warnings
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Environmental Hazards
Legal Issues
Family Issues -
Does the Person have Warnings
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Documentation required to upload to Supportability
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Above Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Medical Conditions
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Open Medical Conditions
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Does Person have a medical Condition
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Is Documentation Available
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Referral made to appropriate medical specialist
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Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Medication
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Open Medication
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Supporting Documentation Required
- Clarification of Purpose
- Authorisation for Administration
- Medication Summary
- Informed Consent for Medication Administration
- None Required
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Above Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Behaviours
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Open Behaviours
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Does the Person have Challenging Behaviours
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Documentation Required
- PBSP
- TIM
- Other
- Not Available
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Documentation required to upload to Supportability
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Referral needs to be made to who
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Referral Completed
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Above Documentation has been uploaded to Supportability
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Is staff Training required
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Training Required
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Section Complete
Routines
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Open Routines
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Is a Support Plan Required
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Plan has been uploaded to Supportability
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Is staff Training required
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Training Required
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Section Complete
Disability Notes
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Open Disability Notes
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Disability Notes have been completed in Supportability
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Section Complete
About Me
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Open About Me
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About Me has been completed in Supportability
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Section Complete
Disabilities Summary & Medical Information
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Open Summary & Medical Information
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Documentation Required
- Asset Register
- Birth Certificate
- Companion Card
- Concession Card
- Evidence of Diagnosis
- Medicare Card
- Other
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Document Type
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Documentation has been uploaded to Supportability
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Section Complete
Mobility
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Open Mobility
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Does the person have Mobility issues
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Is there a Manual handling Plan
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Referral needs to be made to who
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Referral completed
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Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Communication
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Open Communication
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Does the person have Communication issues
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Is there a Communication Plan
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Referral needs to be made to who
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Referral completed
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Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Eating & Nutrition
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Open Communication
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Does the person have Eating & Nutrition issues
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Is there a Eating & Nutrition Plan
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Referral needs to be made to who
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Referral completed
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Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Toileting & Personal Care
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Open Toileting & Personal Care
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Does the person have Toileting & Personal Care issues
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Is there a Toileting & Personal Care Plan
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Referral needs to be made to who
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Referral completed
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Documentation has been uploaded to Supportability
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Is staff Training required
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Section Complete
Contacts and Final Checklist
Contacts
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Open Contacts
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All Relevant Contacts have been entered into Supportability
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For Example
Next of Kin
Legal Guardian
Family Contact Person
Public Trustee
DSQ Case Manager
Dept of Housing Manager -
Section Complete
Documentation Uploaded
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Open Documentation
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Documentation uploaded to Supportability
- Medical
- Legal
- Behaviour
- Media Consent
- Medication
- Other
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Medication Documents Uploaded
- Clarification of Purpose
- Authorisation for Administration
- Medication Summary
- Informed Consent for Medication Administration
- None Required
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Behaviour Documentation Uploaded
- PBSP
- TIM
- Other
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Behaviour Documents Uploaded
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Section Completed
Staff Training
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Open Staff Training
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Staff Must be Trained in the Following Areas
- Behaviour
- Medication
- Identified Medical Plans
- Mobility
- Communication
- Eating & Nutrition
- Toileting & Personal Care
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Section Complete
Declaration of Completion
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I confirm that all of the above information and Documentation has been uploaded to Supportability. The Clients Supportability Profile is now complete Suitably Trained Staff may now be Rostered for Support
