Sections 1 and 2: background information and all about me
Section 1 - Background information
- name
- a photo or picture of you
- date of birth
- address
- phone number
- email address
- emergency contact details
- who do you live with?
Who is in my life?
List your:
- family
- friends
- paid support
Section 2 - all about me
- my first language is
- other languages I use are
- I consider myself to have mental health difficulties - yes or no
- if yes, they have the following effects on my daily life
- I consider myself to have special educational needs or disabilities? - yes or no
- my diagnoses are
- I consider my needs to be
- I feel uncomfortable/overwhelmed in the following situations
- I use the following strategies to support me when I feel uncomfortable/ overwhelmed
- my interests and hobbies are:
- in school I enjoy
- outside of school I enjoy
- I prefer to spend time with - lots of people, just a few people or one other person