This section relates to general consent and is not referring to giving consent for general GDPR purposes. Do we need to add more info here? 

Consent questions Yes / No 

  • Do you give consent to the care provider to discuss information about you with key professionals?  
  • Did the care provider have to contact you first before speaking with other professionals about you?  
  • Do you give consent to the care provider to contact your GP and share, receive and report information about you?  
  • Do you consent to the activities listed in your care plan?  
  • Do you consent for us to design risk assessment on behalf of you to mitigate your risks?  
  • Do you consent to the care provider to carry out regular care plan reviews regards to your care?  
  • Do you consent to the care provider carrying out regular spot checks and observation on the care workers in order to ensure that provider the right service for you?  
  • Are you able to sign this resource? If not, please specify why and who would sign in the “No” section.

Client signature: 

Date: 

Representative signature: 

Date:  

Relationship to the client:  

Assessor signature:  

Date:  

Is there any referrals that need to be made prior to the care plan commencing?  

Date of completion of the referral and outcomes: 

Care manager signature: 

Date: 

Please list who has included in the design of this care plan: 

Date of next Care / Support Plan review:  

(frequency of review to be agreed and documented).  

If the care plan changes, it is good practice to have a sign sheet or a pop-up box for the care professionals to acknowledge that they have read the updates.