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 document? If not, please specify why and who would sign in the “No” section.    

Client signature:


Representative signature:


Relationship to the client:

Assessor signature:


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:


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.