The New Support Arrangement form should be completed as soon as you have all the information required and has been approved by the relevant parties. Please provide as much detail as possible.

All Fields with a * must be completed or the form will not be sent.

1. 1. Please enter the supported person’s full name, date of birth and address
      
      

   2. If known, enter the supported person’s telephone number, Care First Number and National Insurance number. This information can be provided at a later date
      
      

   3. If known, enter the person’s gender and diagnosis
      
      

   4. Enter the start date, the supporting service, and the team the person will be attached to
      
      

   5. If known, detail the breakdown of day support hours and waking night support hours. If the support is an STI give details of the duration.  These fields are not mandatory but give as much information as possible
      
      

   6. Enter the total amount of hours to be delivered per week. This should match the total entered above. This field is mandatory
      
      

   7. Enter details of any other funded support costs
      
      

   8. If the person accesses the service-based sleepover click “Yes” and then click submit. If the person does not have access, click “No”
      
      

   9. If the person accesses a shared or individual sleepover click “Yes” and enter how many nights per week are provided
      
      
      
      
      
      

      Once submitted the form will be sent to support.changes@key.or.uk where all relevant parties will access it.  A copy of the information will be sent to your email address.