Clemens Health | Skill-practice planning brief
Updated 2026-10-05 | (651) 354-1196

Download this editable worksheet, add your notes, and bring it to the relevant planning conversation. Leave unknown details blank and identify who can confirm them.

Agreed skill
Which goal has the person and team chosen to work on?
Your notes: ________________________________________

Real opportunity
Where and when might the skill be useful in the person’s routine?
Your notes: ________________________________________

Preferred tools
What reminders, materials or accessible formats does the person want?
Your notes: ________________________________________

Pace and feedback
How will the person ask for a break or a different approach?
Your notes: ________________________________________

Review note
What should be recorded after practice, and who will review it?
Your notes: ________________________________________

Illustrative example
An adult wants to practice planning a bus trip. They prefer reviewing one familiar destination with a worker before considering another route. The team records that preference and the questions about travel arrangements, instead of treating travel practice as permission to travel alone.

Next step
Ask the provider to explain the proposed approach against the authorized plan. Keep changes to the learning goal or support arrangement visible to the responsible team.

This is an optional discussion worksheet, not an official assessment, authorization, service plan, or emergency plan. Keep completed copies private and share through an agreed channel.