The care plan
The one document that holds the whole picture: who your loved one is, what we're working toward in each area of life, who the professionals are, and exactly what EverPath will do each month. Here's the blank template — print it to bring to your first meeting, or just see what we'll build together.
This is a blank template to print. Nothing is typed or saved on this website — we fill it in together, on paper or in the secure tool we're building.
Who this is for
- Name
- Date of birth
- Plan period
- Guardian(s)
- Waiver and plan
- Prepared by and date
About them — strengths, what matters to them, how they communicate, what a good day looks like
The seven areas of life
-
Health & safety
Medical, dental, and vision care; medications; safety at home and out.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Friends & relationships
Chosen relationships beyond paid staff and family.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Home & daily living
Where and how they live; the daily help in place; their say over it.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Community & activities
Getting out, doing chosen things, being known by people.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Services & supports
The approved supports actually showing up, and valued.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Approved vs. delivered services
Every approved service actually delivered.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
-
Staying coordinated
Appointments, providers, and paperwork not slipping.
- Where things are today
- Goal for this plan period
- EverPath's responsibility here
- How we'll know it's working
The three guardrails
The professional scaffolding that keeps the plan on track.
-
Legal alignment
Estate plan, guardianship or conservatorship, trusts, and powers of attorney stay lined up with today's life.
- Who holds this (the attorney or legal team) and how to reach them
- What must stay lined up
- How EverPath keeps the loop closed
-
Financial alignment
Benefits, resources, and planning stay organized and current.
- Who holds this (the financial professional or benefits worker) and how to reach them
- What must stay lined up
- How EverPath keeps the loop closed
-
Coordination & follow-through
Responsibilities, reminders, documents, and concerns are tracked — and actually happen.
- Who holds this (EverPath) and how to reach them
- What must stay lined up
- How EverPath keeps the loop closed
What EverPath will do, and how often
| Responsibility | How often | Who receives it | How |
|---|---|---|---|
| Monthly check-in across the seven areas | |||
| Written update to the family | |||
| Review of approved-vs-delivered services | |||
| Legal-team touchpoint | |||
| Financial / benefits touchpoint | |||
| Follow-up on open action items |
Signed and on file
- Service agreement signed
- Release of information / consent to coordinate
- Emergency contacts on file
- Guardianship or power-of-attorney documents on file
- This plan and its goals reviewed and signed
Agreement
We've reviewed this plan together. It reflects your loved one's goals and EverPath's specific responsibilities for the period above, and we'll revisit it as things change.