It is never too early to plan and practice how to care for yourself or direct others to help. Creating a plan and sharing it with your parents may help you and your parents feel more comfortable.


Whether you are preparing for your first visit away from home or are planning your first longer stay to an unfamiliar place, these worksheets will help you think of things you may not have considered. Don’t let the number of questions make you nervous or give up.  Not all questions or worksheets may apply to your situation. If you get stuck, ask your parents, nurse or doctor for help.


Once you have filled out the worksheets you need, don’t forget to practice.  Before leaving home, practice taking your medicines or doing your procedures in a different place than usual.  Ask your parents to help quiz you on what to do in different situations.  For example, how would you handle an emergency? What will you do if you feel uncomfortable? How will you ask others for help?

  • Note: You can download the Worksheets individually or download all of the worksheets at once.


Worksheet Covers questions such as:
Diagnosis Information
How do you describe your health condition to others? Do you have a written health history summary? What health care records might you need?
Medicines What types of medicines do you need and why? What happens if you don’t take them? What should you do if you forget to take them? What will you do if you lose your medicines?
Daily Health Care Tasks and Treatments What are your daily health care tasks and treatments? How will that change if you are away from home? If you need more supplies while away, where will you get them and how will you pay for them?
Safety and Warning Signs
What safety issues may be in your new environment? Are there special things that you should avoid? What will you do if you don’t feel well? What should others do if you don’t feel well?
Where would you go for urgent medical care? Do you know how to call the local emergency number? Will you have a cell phone available and will it work? How will you plan for transportation in an emergency?
Seeing Health Care
Providers While Away
Where would you go if you need to see a doctor? How would you get there? Are you comfortable giving your medical history to a new doctor? Do you need a letter from your parents giving you permission to be seen?
Insurance/Payment for
Health Services
How will you pay if you need medical treatment? What does your insurance pay and not pay for? Does it work if are in another state or if you see a health care provider that is not your normal providers?
Key Contact Information
Who are your important contacts (doctor, nurse, pharmacy, etc.)? Where will you carry your key contact information while you are away?
Support When Away
What should you do if your are worried about your health condition and want to talk to someone? Who knows about your condition?
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