Family Support Worksheet

Fill out as you think through your family’s needs

Many families need support from community resources and the first step to finding the best fit is thinking through concerns and considering the type of help you would like to receive. Having these details handy during your provider visit will make it easier to tell your story to the people who can help.

Answer the questions below to describe the areas where your family might need support.

Describe your concern. Be detailed and provide examples.

  1. How long have you noticed this concern?
  2. Which programs or services have you contacted before for help in this area? How else have you approached this situation? What worked well? What did not work well?
  3. What type of help would you like to receive? What change would it make for your family?


The details you wrote above are a summary of your concern. Next, think about how to find the support you would like to receive.

  1. Is there a person or a program in the community who currently helps you with this or other concerns? List those names and programs here.
  2. Who do you trust to talk with about your concerns? (For example, your doctor, child’s teacher, family, other parents in the community, etc.) List the names of people you feel comfortable asking for advice about finding support.

Some families find it easiest to locate support by talking to trusted people already in their lives. The names you wrote above may be a good place to start. There are also free, confidential parent resources such as 1-800-CHILDREN that are available 24-hours a day to assist you with your search.