STEP 1 - Getting Plan Ready
Participant Statement Workbook
This Participant Statement workbook is to Completing the Participant Statement
help you with STEP 1 – Getting Plan
helps the National Disability Insurance
Ready.
Agency (NDIA – the agency) with the
information we need to complete your (or
It includes activities to help you to think
your child’s) NDIS plan with you
about your (or your child’s) needs and
including:
goals now and in the future.
 your (or your child’s) situation
The next steps in the planning process
 what you (or your child) would like
are:
to achieve
STEP 2 – having your Planning
Conversation with the National Disability
Insurance Agency (NDIA), the time this
takes can be different for each participant
STEP 3 – Plan Implementation
STEP 4 – Monitoring
STEP 5 – Plan Review
Please fill in this workbook and give it to
the agency before your first planning
conversation. There are Plan Readiness
workshops that you can attend to help
you. You can also bring any other
information that would help the planning
conversation.
1
My (or My Child’s) Participant Statement
This information will help the agency to learn about me (or my child) and support the
conversations they will have with me to develop my (or my child’s) NDIS Plan.
Full Name (and preferred name)
NDIS Number
How much help did you need to complete
this workbook?
☐No help ☐Some help ☒Complete help
If you had help completing this workbook on please tell us:
Name of people who helped fill in this
workbook
Relationship to the participant
(Example: Mother, Father, Guardian,
Nominee, Friend, Advocate, Community
Connector)
Part 1: About me / my child
This part of my (or my child’s) Participant Statement is about me (or my child), my (or my
child’s) life, and the people in my (or my child’s life). I understand that this will be included
on my (or my child’s) NDIS Plan and if I consent will be able to be seen by my registered
providers.
TIP: It is a good idea to be clear who is answering the questions.
Example: I live with my Mum (Sarah) and Dad (Simon)…. OR;
Matthew lives with us, his Mum (Sarah) and Dad (Simon)….
Where I live and the people I live with
What are your (or your child’s) current living arrangements?
Example:
 Who do you (or your child) usually live with?
 What sort of home do you (or your child) live in?
2
People in my life who support me
Who are the important people in your (or your child’s) life and how do they help you?
Example:
 Family and friends, doctors, teachers, carers or others you (or your child) see often
(you might have included some of these people on your Access Request Form)
 Any other people who play an important role in your child’s life
My daily life
What happens in your (or your child’s) day to day life for social and work related activities?
Example:
 What do you (or your child) do regularly during the day (education, school, sport,
social activities, volunteering and work)?
 What things are working well?
 What are the things you (or your child) enjoy?
 What are the things you (or your child) are good at?
 What would you (or your child) like to change?
TIP: You can use the calendar on page 8 to help you
3
Part 2: My Goals
This part of my Participant Statement lists my (or my child’s) goals and things I want to
work towards during this plan.
Think about your (or your child’s) goals, big (Life Goals that might take longer to work
towards) or small (goals that could be worked towards in a short time during the Plan).
Imagine how your (or your child’s) life could be and what supports you (or your child)
might need to work towards and achieve those goals.
Goals to be independent and do ordinary day to day things
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Doing more things for yourself/themselves
Learn new life skills and become more independent
What is it you (or your child) want to change or achieve?
Are there things in your daily life you (or your child) would like to
maintain or keep the same?
Goals about doing things in your community
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Spending more time with other people in your community
Making more friends or spending more time with family
Trying new activities, like joining a club or group
Being more able to attend events
Goals around building relationships with family and friends
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Are you (or your child) happy with the relationships in your (their)
life?
Are you (or your child) having difficulty in social situations or with
getting along with your (their) friends, family or other people in your
(their) life?
What would you (or your child) like your relationships to look like?
Goals to be independent at home
 Does your current home suit your (or your child’s) needs?
 Do you need to change where you (or your child) live?
 Do you need some help to make sure you (or your child) stay
living where you are?
4
Goals for learning something new or improving skills
 Like a new skill or qualification?
 Are you (or your child) starting or moving to a new school or other form of
education?
 What do you (or your child) want to achieve?
Goals for learning something new or improving skills
 Are you happy with the control that you (or your child) have over the
choices you (they) make in daily life?
 Do you (or your child) need help to make choices about who
supports you and when?
Goals for improving or maintaining health and wellbeing
 Do you (or your child) want to get healthier, change your diet or do more
physical activity, like taking up a sport?
 What is it you (or your child) want to change or achieve?
Goals for finding, getting and keeping a job (paid or volunteer)
 Do you (or your child if nearly 15 or over 15 years of age) want to
get a job or volunteer?
 Do you want to increase your work or volunteer hours?
 Does anything need to happen before you (or your child) are job ready?
 Do you (or your child) need anything to keep you being able to work?
5
GOAL EXAMPLE:
My first (1st) goal is: To ride a bike by myself without anyone pushing me along
During this plan I want to: build my strength in my legs
During this plan I want to: be able to go for a bike ride with my sisters, mum and dad.
Add your goals below. The agency encourages you to have at least one goal and at least
one thing you want to do during this plan. Having too many goals makes it harder to keep
focus and achieve them.
Think about the things you (or your child) want to change or do now or in the next few
years. Think about what or who (informal, community, mainstream or disability and
developmental delay supports could help to achieve this goal (see pages 10 – 12 for
examples).
My first goal is:
_______________
During this plan I want to:
_________________________________
During this plan I want to:
_________________________________
The informal, community and mainstream support I can use to help me are:
_________________________________
_________________________________
_________________________________
_________________________________
My second goal is:
_______________
During this plan I want to:
_________________________________
During this plan I want to:
_________________________________
The informal, community and mainstream support I can use to help me are:
_________________________________
_________________________________
_________________________________
_________________________________
6
My third goal is:
_______________
During this plan I want to:
_________________________________
During this plan I want to:
_________________________________
The informal, community and mainstream support I can use to help me are:
_________________________________
_________________________________
_________________________________
_________________________________
My fourth goal is:
_______________
During this plan I want to:
_________________________________
During this plan I want to:
_________________________________
The informal, community and mainstream support I can use to help me are:
_________________________________
_________________________________
_________________________________
_________________________________
My fifth goal is:
_______________
During this plan I want to:
_________________________________
During this plan I want to:
_________________________________
The informal, community and mainstream support I can use to help me are:
_________________________________
_________________________________
_________________________________
_________________________________
7
My (my child’s) activities calendar
Completing this calendar can help you to complete your (your child's) NDIS Participant Statement. Think about activities that you do (or your child does)
regularly, for example, attending school/ pre-school or child care, family activities, social activities with friends, sports, music and dancing and any therapy,
appointments for services (including speech pathology, OT and physio). The next page has space to add activities or regular events and notes.
Wednesday
Thursday
Friday
Saturday
Sunday
1am – NOON
Tuesday
6pm - Midnight
Night
NOON – 6pm
Afternoon Morning
Monday
8
Sometimes I do (my child does)…..…..
List activities such as holidays that your child does sometimes
Notes:
9
Part 3: My Supports
These are the supports that will help me to work toward my goals, you might have already
listed some when you were thinking about your goals. Now you can bring them all together
and see if there is any missing?
Family and friends
This is what the NDIS call ‘informal’ supports.
Tell us about the informal supports you (or
your child) have that you think could help to
achieve the goals and things you want your
child to do during this plan.
(E.g. parents, friends, siblings, grandparents)
Who will provide the support?
Type of support
Example: Mum and Dad
Example: help me learn to ride my bike and take
me on bike rides on weekends
10
Services and community groups
These supports might include things like health or mental health services, schools or
education services, community groups, sporting or hobby clubs or other government
services. This is what the NDIS call ‘mainstream and community’ supports.
Tell us about the community and
mainstream supports your child has
now and the ones that you think could
help to achieve the goals and things
you want your child to do during this
plan to work towards those goals.
(E.g. schools, pre-schools, sporting and social
clubs, and community groups)
Who will provide the support?
Type of support
Example: School
Example: Let me ride my bike at school
bike education class
11
Anything else
Anything else you would like us to know about your child’s needs including the areas they need
support or have difficulties with, due to their developmental delay or disability.
Tell us about the Developmental Delay or Disability supports your child has now to help
with their needs and the ones that you think could help to achieve the goals and things
you want your child to do during this plan to work towards those goals.
(E.g. therapy, mobility assistance, communication assistance, equipment, self-care, home and vehicle
modifications))
Type of support
Example: Occupational Therapy to help build muscle strength in legs to push bike pedals
Example: Modifications to bike so that can pedal independently
12