[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-240993-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-240993-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","gt-6ce-leaving-plan-care-f","GT-6CE-Leaving-Plan-Care-F","","This document provides a sample Plan of Care for healthcare transition, designed to be collaboratively developed by youth and their parent/caregiver. It integrates health and personal goals, using information from transition readiness assessments to set actionable objectives. The plan emphasizes frequent updates and inclusion in the transfer package to the new adult clinician. It includes sections for preferred and legal names, date of birth, primary and secondary diagnoses, and a critical question: 'WHAT MATTERS MOST TO YOU AS YOU BECOME AN ADULT? HOW CAN LEARNING MORE ABOUT YOUR HEALTH NEEDS AND LEARNING HOW TO USE HEALTH CARE SUPPORT YOUR GOALS?'. The core of the plan is a table to detail youth's prioritized goals, transition issues or concerns, corresponding actions, responsible parties, target dates, and completion dates. It also includes spaces for clinician/care staff information, signatures, and dates of creation/update, along with youth and parent/caregiver signatures, reinforcing the collaborative and documented nature of the transition process. This sample plan adheres to the Six Core Elements of Health Care Transition™ 3.0 framework, copyright © 2020 by Got Transition®, permitting non-commercial use with proper attribution.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/gt-6ce-leaving-plan-care-f/240993/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/gt-6ce-leaving-plan-care-f/240993.png","ImageObject",442,249,{"name":42,"@type":43},"Levi","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-11",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the primary purpose of this sample Plan of Care?","Question",{"text":63,"@type":64},"The sample Plan of Care is created jointly with youth and their parent/caregiver to set goals and outline a plan of action that combines health and personal goals for the transition to adult healthcare.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What information is included in the sample Plan of Care?",{"text":68,"@type":64},"The plan includes spaces for personal and medical information, prioritized goals, transition issues, actions, responsible parties, target dates, and completion dates, along with signatures from the youth, parent/caregiver, and clinician.",{"name":70,"@type":61,"acceptedAnswer":71},"How often should the Plan of Care be updated?",{"text":72,"@type":64},"The Plan of Care should be updated often and sent to the new adult clinician as part of the transfer package.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},240993,1791210284,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":4},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","THE SIX CORE ELEMENTS OF HEALTH CARE TRANSITION™ 3.0  \nSample Plan of Care  \nThis sample plan of care is created jointly with youth and their parent/caregiver to set goals and outline a plan of action that combines health and personal goals  . Information from the transition readiness assessment can be used to develop goals  . The plan of care should be updated often and sent to the new adult clinician as part of the transfer package  .  \n\n| Preferred name | Legal name | Date of birth |\n| --- | --- | --- |\n\nPrimary diagnosis Secondary diagnosis  \n\n| WHAT MATTERS MOST TO YOU AS YOU BECOME AN ADULT? HOW CAN LEARNING MORE ABOUT YOUR HEALTH NEEDS AND LEARNING HOW TO USE HEALTH CARE SUPPORT YOUR GOALS? |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- |\n| Youth’s Prioritized Goals | Transition Issues or Concerns | Actions | Person Responsible | Target Date | Date\u003Cbr>Completed |\n|  |  |  |  |  |  |\n|  |  |  |  |  |  |\n|  |  |  |  |  |  |\n\n| Clinician/Care staff name |  | Date plan created/Updated |\n| --- | --- | --- |\n| Clinician/Care staff contact information | Clinician/Care staffsignature |  |\n\nYouth signature Parent/Caregiver signature  \n1  \nTransitioning Youth to an Adult Health Care Clinician  \nSix Core Elements of Health Care Transition™ 3.0  \n© 2020 Got Transition®. Non-commercial use is permitted, but requires attribution to Got Transition for any use, copy, or adaption.","cbCailojFY0ycTY4","https://ap.wps.com/l/cbCailojFY0ycTY4","pdf",187825,"English","# THE SIX CORE ELEMENTS OF HEALTH CARE TRANSITION™ 3.0\n# Sample Plan of Care\n## Youth’s Prioritized Goals\n## Transition Issues or Concerns\n## Actions\n## Person Responsible\n## Target Date\n## Date Completed\n# Clinician/Care staff name\n# Clinician/Care staff contact information\n# Clinician/Care staff signature\n# Youth signature\n# Parent/Caregiver signature\n# Transitioning Youth to an Adult Health Care Clinician\n# Six Core Elements of Health Care Transition™ 3.0","[{\"question\":\"What is the primary purpose of this sample Plan of Care?\",\"answer\":\"The sample Plan of Care is created jointly with youth and their parent/caregiver to set goals and outline a plan of action that combines health and personal goals for the transition to adult healthcare.\"},{\"question\":\"What information is included in the sample Plan of Care?\",\"answer\":\"The plan includes spaces for personal and medical information, prioritized goals, transition issues, actions, responsible parties, target dates, and completion dates, along with signatures from the youth, parent/caregiver, and clinician.\"},{\"question\":\"How often should the Plan of Care be updated?\",\"answer\":\"The Plan of Care should be updated often and sent to the new adult clinician as part of the transfer package.\"}]","GT-6CE-Leaving-Plan-Care-F | PDF",1789168672]