Complete Choice

0414 890 464 / 0466 057 770

info@completechoice.com.au

39 John St, Salisbury, SA 5108

F29-New-Participant-Risk-Assessment-Revised-correction-2022

F29-New-Participant-Risk-Assessment-Revised-correction-2022

Form CPRO 2 PARTICIPANT DETAILS

Participant Requirements / Preferences

Known Medical Conditions or Allergies

Emergency Contacts

CARER / GUARDIAN DETAILS

Postal address
Postal address
City
State/Province
Zip/Postal
Country
Specify frequency for participants who live alone:

Persons Involved in Risk Assessment

Was the participant involved in the assessment?

Daily Personal Activities – including participants living alone

Support Worker
(If yes, a Monitoring and Supervision Plan is required)

Information Sharing and Privacy

Privacy Policy Explained
Sharing information

STEP 1. IDENTIFY RISKS

Daily Personal Activities Support – for participants living alone

Personal contact
Physical Mobility
Communication

Note: If supports will be delivered by sole support worker, and any of the above risks apply, a
Monitoring and Supervision Plan must be created.

Medical conditions and interventions
Personal care
Eating and drinking
Accidental movement
Manual handling
Environmental risks
Mental health and wellbeing
Financial risks

Financial risks

Checkboxes