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Individual Service Plan - example - Interchange WA

Interchange Inc Commercial-in-Confidence Individual Service plan / I-OPS-2010-0011 11/11/2011 - Version 1 Individual Service plan Customer Name: Billy West DOB: 22/01/1985 Address: 18 Eastern Terrace Myaree, WA 6154 Ph: 9200 2020 Ph: 0422 200 222 Key Worker: Reg Caremore Date of plan : 18/08/2011 Review Date: 10/07/2012 PART ONE: Individual Service CONSIDERATIONS Customer Family/Group Home Interchange Unsteady on feet Requires healthy food Lives with parents No transport issues Billy lives within 15 minutes from Myaree office. Selective pairing with other clients.

part four: our individual service plan agreement We agree to work together as partners to achieve the goals in this Interchange Service Plan and to take an active part in the strategies that have been outlined.

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