Effective Date: 



Updated: 9/2012


Form is sent to obtain input from the legally authorized representative (LAR), family, advocate and/or correspondent in the planning and development of the Personal Support Plan (PSP).


When to Prepare

Send with invitation letter six weeks before the scheduled PSP meeting.

Responsible Party

Qualified intellectual disability professional (QIDP) or designee.


LAR, family, advocate and/or correspondent.

Form Retention

QIDP files returned questionnaire in QIDP file.

Detailed Instructions

  • Form to be completed by LAR, family, advocate and/or correspondent and returned to QIDP two weeks after sending invitation. Return date is noted in invitation letter.
  • QIDP reviews returned form and disperses information to disciplines if needed.
  • QIDP incorporates information into Form 6600, Personal Support Preparation Worksheet, agenda, etc.

Having trouble viewing or downloading a form?

Get Help