Therapy recommendation care-team workbook An action record, clinician clarification message and observation note. This organiser does not authorise a worker to deliver a clinical intervention. Prepared 22 September 2026. Full guide and official source links: https://www.kinovo.com.au/resources/share-therapy-recommendations-support-workers Recommendation-to-action record Keep the current clinician-authored instructions attached or linked. Do not invent or shorten clinical instructions to fit this card. Participant / preferred name and date: ___ What the participant wants help with, in their words: ___ What they agree can be shared, with whom and why: ___ Clinician name, role and contact: ___ Original recommendation title, date, version and location: ___ Everyday situation this recommendation applies to: ___ Specific action confirmed by the clinician as suitable for this worker: ___ Worker / provider and confirmation they accept this responsibility: ___ Training, demonstration, competence or supervision needed: ___ Who confirms readiness, and when: ___ Unanswered questions / what must wait for clarification: ___ Clinician's limits, stop guidance and contact route: see ___ Feedback requested by the clinician and where to send it: ___ Review date / person responsible for checking the current version: ___ Status: awaiting clarification / preparation needed / confirmed ready / under review Ask the clinician to clarify the handover Use this before an unclear recommendation becomes a worker instruction. Adapt the questions to the actual activity. Subject: Clarifying how [recommendation] applies during [everyday routine] Hi [clinician], With [participant's] agreement, we are organising the handover of [document and date]. They want support with [everyday goal]. The point we need clarified is [specific wording or situation]. Which parts, if any, are appropriate for this support worker to assist with? What training, demonstration or supervision is required first? Who should confirm the worker is ready to provide that assistance? Please confirm any limits, when to stop, and who to contact with concerns. What observations would be useful, and how often should we send them? Is this the current version, and when should it be reviewed? We have marked the unclear action as awaiting clarification. Could you confirm the next step and an expected response date? Thank you, [name and role] Factual feedback for the care team Record relevant observations and the participant's perspective using the agreed channel. This is not a diagnosis, clinical assessment or replacement for required provider records. Date / time / everyday setting: ___ Person writing this note and role: ___ Current recommendation referenced (title and date): ___ What the participant wanted to do or said about the activity: ___ Agreed support actually provided: ___ What I directly saw or heard: ___ Anything that made this situation different: ___ Participant's response or feedback, in their own words where possible: ___ Question for the clinician / supervisor: ___ Action already taken through the agreed support or incident process, if relevant: ___ Sent to the appropriate person by / on: ___ Response or clarification still needed: ___ Next review or check-in: ___ For urgent concerns, use the existing urgent or emergency pathway; do not wait for a shared note to be read. 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.