Preparation tool · Blank printable worksheet
School, daycare, and activity-support plan
A blank coordination sheet for contacts, access needs, observations, recovery notes, and the location of a clinician-approved plan.
Use this sheet to coordinate practical support with the family, education or care setting, and clinical team.
Contacts and plan location
Family or caregiver contact
School, daycare, or activity-setting contact
Clinical or therapy contact
Where the current clinician-approved plan is stored
Plan review date
Access and assistance
Access to food and fluid
Access to rest or a quieter space
Mobility, positioning, or transfer assistance
Equipment and accessibility arrangements
Communication and follow-up
Observations the agreed plan asks staff to report
How and when to contact the family or care team
Recovery or return-to-activity notes from the approved plan
Questions or next review items
Limits of this tool
- The prompts do not create legal entitlements or replace school, daycare, workplace, or clinical documentation.
- Needs can change with health, function, setting, and local policy; the responsible team should review the completed plan.
Public-use and source-boundary review recorded Sep 5, 2026. This is not named clinical approval.