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My support needs
My morning schedule:
| Time (AM) | What I do that I would like support with. Be specific when describing the supports that you need. | Hours of unpaid support available | Hours of paid support needed | Hours that can be reduced by technology |
|---|---|---|---|---|
| Total hours needed: | ||||
My afternoon schedule:
| Time (PM) | What I do that I would like support with. Be specific when describing the supports that you need. | Hours of unpaid support available | Hours of paid support needed | Hours that can be reduced by technology |
|---|---|---|---|---|
| Total hours needed: | ||||
My evening schedule:
| Time (PM) | What I do that I would like support with. Be specific when describing the supports that you need. | Hours of unpaid support available | Hours of paid support needed | Hours that can be reduced by technology |
|---|---|---|---|---|
| Total hours needed: | ||||
Overnight support:
| Time | What I do that I would like support with. Be specific when describing the supports that you need. | Hours of unpaid support available | Hours of paid support needed | Hours that can be reduced by technology |
|---|---|---|---|---|
| Total hours needed: | ||||
Use this section for activities that do not happen every day (only complete this if these activities have not been recorded above).
Weekly support schedule:
| Day andtime | What I do that I would like support with. Be specific when describing the supports that you need. | Hours of unpaid support available | Hours of paid support needed | Hours that can be reduced by technology |
|---|---|---|---|---|
| Total hours needed: | ||||