Author: SMP

Enter your full name

Click Here To Insert Your Picture

Type in this box to share general information about you, like who you are and what is most important to you in life.

Enter Person’s Name

Type here to explain why you chose this person

Insert Picture

Insert Picture

My Human Security
Share what you want people to know about your human and civil rights.

My Community
Share what you want people to know about your community participation.

Insert Picture

My Relationships
Share what you want people to know about intimacy, friendships and more.

Insert Picture

My Choices
Share what you want people to know the decisions you make.

Insert Picture

My Goals
Share what you want people to know about your hopes and dreams.

Insert a Picture

Describe the picture to the left

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Describe the picture to the right

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Describe the picture to the left

Insert a Picture

Who is in the picture to the left?
Why are they important?

Insert a Picture

Insert a Picture

Who is in the picture above?
Why are they important?

Who is in the picture above?
Why are they important?

Who is in the picture to the right?
Why are they important?

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Insert a Picture

Describe the picture above

Describe the picture to the right

Insert a Picture

Insert a Picture

Insert a Picture

Describe the above activity

Describe the above activity

Describe the activity to the right

Insert a Picture

Insert a Picture

Insert a Picture

Insert a Picture

Describe the above activity

Describe the above activity

Describe the above activity

Describe the picture to the right

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Describe the picture above

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Describe the picture to the right

Insert a Picture

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Describe the picture to the left

Describe the picture to the right

Insert a Picture

Insert a Picture

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Describe the picture above

Insert a Picture

Insert a Picture

Describe the picture above

Describe the picture above

Insert a Picture

Describe the picture above

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Insert a Picture

Describe the picture to the left

Goal #1

Enter Goal Title Here

Insert a Picture

BENCHMARKS:
ACHIEVING THE GOAL
Benchmark Title
Benchmark Title
Benchmark Title
Benchmark Title

Type in this box to share more information about this goal.

Goal #2

Enter Goal Title Here

Type in this box to share more information about this goal.

Insert a Picture

BENCHMARKS:
ACHIEVING THE GOAL
Benchmark Title
Benchmark Title
Benchmark Title
Benchmark Title

Goal #3

Enter Goal Title Here

Insert a Picture

BENCHMARKS:
ACHIEVING THE GOAL
Benchmark Title
Benchmark Title
Benchmark Title
Benchmark Title

Type in this box to share more information about this goal.

Goal #4

Enter Goal Title Here

Type in this box to share more information about this goal.

Insert a Picture

BENCHMARKS:
ACHIEVING THE GOAL
Benchmark Title
Benchmark Title
Benchmark Title
Benchmark Title

Goal #5

Enter Goal Title Here

Insert a Picture

BENCHMARKS:
ACHIEVING THE GOAL
Benchmark Title
Benchmark Title
Benchmark Title
Benchmark Title

Type in this box to share more information about this goal.

Insert a Picture

Goal #1 - Enter Goal Title Here
Type in this box to share how you will celebrate Goal #1

Insert a Picture

Goal #2 - Enter Goal Title Here
Type in this box to share how you will celebrate Goal #2

Insert a Picture

Goal #3 - Enter Goal Title Here
Type in this box to share how you will celebrate Goal #3

Insert a Picture

Goal #4 - Enter Goal Title Here
Type in this box to share how you will celebrate Goal #4

Insert a Picture

Goal #5 - Enter Goal Title Here
Type in this box to share how you will celebrate Goal #5

* Type Your Name Here *

My Person-Centered Plan

Funded by the Illinois Council on Developmental Disabilities:

This template was developed by CQL | The Council on Quality and Leadership www.c-q-l.org

My Future Dreams
How I want my life to be in the future

Supports that I want
Pictures of what I need or want help with

About Me

Some Things I Don’t Like
Pictures of things I do not enjoy in life

Favorite Activities
Pictures of me doing my favorite things

SUCCESS!

Celebrating My Goals How I will celebrate achieving goals

My Health
Important things to know about my health

Some Things I Do Like
Pictures of things I enjoy in life

SUCCESS!

Important People
Pictures of people who matter most to me

My Values:
What I think about things like rights,
religion, voting and other topics

About This Plan
How this person-centered plan works

This plan helps you share information about yourself.
It explains who you are, what your life is like, and what you want to do in the future.
You can add pictures and words to each page, by clicking on the boxes.
You can add pages, delete pages, or make changes to pages.
If you need support with filling out this plan, other people can help you.

… helped me fill out this plan. I chose them because:

My Community
Being included and involved around town

Proud Moments
Things I have accomplished in the last year

During The Day
Pictures of me at work, volunteering or
what I like to do most of the day

My Safety
How I can be supported to feel more safe
(These may be included in your Risk Assessment)

My Person-Centered Plan

My
signature

I,
made this person-centered plan and it is unique to me, based on outcomes that are important to me!

Funded by the Illinois Council on Developmental Disabilities:

This template was developed by CQL | The Council on Quality and Leadership www.c-q-l.org

Extra Information
Other things I want people to know