Backup care information and confirmation workbook
Three optional preparation tools to use alongside the official Carer Gateway emergency care plan. A contact list does not confirm care or replace emergency services.
Prepared 22 September 2026.
Full guide and official source links: https://www.kinovo.com.au/resources/backup-care-information-checklist

Who has agreed to help?
Copy a card for each proposed person or service. Ask first; record the limits of an accepted arrangement and keep unknowns visible.

Participant / date / preference about this person helping: ___
Person or service / phone / contact hours: ___
Status: not asked / awaiting reply / agreed / unavailable
Specific help they have accepted: ___
Days, times and maximum period confirmed: ___
Tasks they cannot do / training or conditions still needed: ___
Who confirmed this arrangement / when: ___
Relevant provider booking or reference, if supplied: ___
Costs, funding or service-agreement questions to resolve: ___
How to contact them if the arrangement is needed: ___
If there is no reply, the next agreed contact or process: ___
Who will confirm the participant is supported: ___
When we will check availability again: ___
For urgent danger or a medical emergency, call 000.


Where is the current care information?
Use alongside the Carer Gateway emergency care plan. Point to current professional instructions; this sheet does not authorise or teach clinical care.

Participant / preferred communication / prepared on: ___
What the participant wants a temporary supporter to know: ___
Emergency care plan / location / date checked: ___
Current professional care instructions / author / location: ___
Medicine information / clinician or pharmacist contact: ___
Routines, preferences and practical arrangements: ___
Relevant appointments / provider contacts: ___
Access arrangements agreed privately with the right person: ___
Who has permission to receive which information: ___
Offline copy / agreed holder / date checked: ___
Who has confirmed they can find and understand the information: ___
Unclear or out-of-date item / person asked to clarify it: ___
Who will keep this index current / next review: ___
For urgent danger or a medical emergency, call 000.


Ask about a backup arrangement
Use this for preparation, not an urgent request awaiting an inbox reply. For emergency respite, call Carer Gateway on 1800 422 737; availability varies.

Subject: Confirming a possible backup arrangement for [name]
Hi [person or service],
We are preparing for times when [usual carer] cannot provide support.
[Participant] would like [preference about how support happens].
Could you discuss helping with [specific support] during [times]?
Please confirm what is possible and anything you cannot provide.
What training, information, consent or booking steps would be needed?
Are there any costs or service conditions we should clarify first?
If this is agreed, how should we contact you when it is needed?
What should we do if you are unavailable or do not answer?
We can share the relevant current information through [agreed channel].
Until confirmed, we will keep this arrangement marked as pending.
Thank you, [name / contact details / preferred reply method]


Optional coordination tool. Not an NDIA form, clinical instruction or funding approval.
Store completed copies appropriately and share only with the people who need them.