Initial Planning Meeting Name*Email address*ReferrerDOBInitial Meeting Date*Time*AttendeesLocation 1st WENWHES completed?*YesNoAny change in your contact details since referral?*YesNoIf yes, please tell us?ScoreSafeguarding?*YesNoRisk Planning?*YesNoAbout youYou / Your family & friends / School, training, or work / How active are you? / Current or past activities / What brought you to US? / Your mental health / How does how you feel affect what you do? / How do you feel about getting active? Personal Goals & InterestsWhat are your reasons for wanting to start sport/exercise?*What do you hope to achieve through participation? *fun / fitness / socialising / confidenceWhat type(s) of sport/exercise are you interested in?*individual / team / outdoor / social What are you long-term goals related to sport/exercise?*Current Wellbeing & ConsiderationsDo you have any mental health challenges that may affect your participation?*What might prevent you from taking part?*Are there any physical health considerations or accessibility needs?*Do you have any worries or concerns about starting?*Support & PlanningWhat kind of support would help you get involved?*buddy system / quiet spaces / flexible sessions / check insAre there any specific considerations needed for your participation?*Any transport or logistical considerations?*Next steps and agreed actions*Safety and Support SafeguardingRisk ManagementProposed PlanShort term - with US / Long Term - to keep activePersonal GoalsMy Personal Goal - 1*My Personal Goal - 2My Personal Goal - 3How will I know if I've achieved my personal goal?How will I know if I've achieved my personal goal?How will I know if I've achieved my personal goal?Progress Catch upWhen we'll catch up What time we'll meetWhere we'll meetRe-checking your consentFirst Aid and Emergency treatmentYesNoInformation on other relevant US ActivitiesYesNoUS Mailing ListYesNoPhoto / Media permissions re. ActivityYesNoPhoto / Media permission for general marketingYesNoSignature to confirm we agree with recorded planYoung PersonParent / CarerUSPlease enable JavaScript to submit this form.Email address*SendThis field should be left blank
