Outreach services - assessment, support and discharge plan (PDF)

This form should be used to provide an initial assessment, support and discharge plan for outreach services to injured workers.

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What it contains

A form to be completed in collaboration with the worker and emailed to their case manager (the Agent).

Outreach Service providers must

  • Consider if Outreach Services are appropriate for the injured worker, prior to commencing services to ensure the referral is appropriate.
  • Submit an Initial Assessment and Support Plan prior to the fifth session with the worker. Further updates and plans will be required if additional funding is needed beyond the approved initial support package.
  • Provide a discharge plan for the worker when they are exiting the service.
  • Complete this form in collaboration with the worker and email to their case manager (the Agent). Please note that this template is a guide, and provided the information below is covered, the layout of the plan is flexible.