PERSONAL PROFILE

Person’s Name:

Information and Training Specific to the Person
Employee Name:	Training Date:
Annual Update Section Update Section	Instructor(s):
I. What you must know about me first. What people admire about me.
II. How do I communicate?
What is Happening?	What Does do?	What we think it means	What others should do
III. Relationships: (Relationship Map Tool)
Family and Friends:	Paid Staff:	Others:
IV: What supports/services do I need to have a Good Day? (Good Day/Bad Day Tool)
V. Things I really like to do and places I enjoy going.
VI: What supports do I need for Activities of Daily Living and what do they look like for me?
VII: How to keep me safe in the event of a fire or natural disaster.
I have implementation or staff instructions that need to be followed (Please mark all that apply and provide the date the instructions were trained)
Speech and Language/Hearing Instructions/Equipment Plan Mealtime Instructions Behavior Support Instructions/Plan Nutritional Instructions Adaptive Equipment Instructions Physical Therapy Instructions Occupational Therapy Instructions Other
Signature of Employee:
Signature of Instructor: