Help someone leave with a usable next step.

For treatment staff, care coordinators and peer-support staff helping adults organize their own care. Use one companion when its task fits the person's immediate need. Offer the longer guide when more explanation or writing space would help.

Choose the task together

Original opening: “Would it help to leave with your key contacts in one place, or a view of this week's appointments?” Offer help reading or writing, the format they prefer, and any language or access support available through your service. Completing a worksheet is optional.

When the person needs someone to contact

My support contacts to keep handy holds three chosen contacts. Start with one real need. Confirm the contact method, what support was agreed, availability, and what to do if that person or service is unavailable. Mark an unanswered item as something to check. Do not imply that a saved name is a confirmed referral or an on-call service.

Original prompt: “If you needed a ride on Thursday, who would you try, and what would you do if they couldn't help?” The card preserves the distinction between ordinary support and the care team's urgent-contact instructions. It is not a crisis plan.

When appointments compete with everyday responsibilities

My week at a glance places appointments beside travel and practical arrangements. Use the actual schedule. Confirm one visit from beginning to end: arrival time, location, getting home, work or caregiving, and the contact to use if plans change. Mark tentative arrangements as unconfirmed. NIAAA's alcohol-treatment guidance encourages asking about session schedules and program expectations. [2]

Original prompt: “Talk me through getting to Tuesday's appointment and home again. What is still missing?” If a conflict is unresolved, agree who will check options and when. The sheet does not choose the treatment frequency or replace clinical instructions.

Check your explanation

AHRQ describes teach-back as asking people to explain in their own words what they need to know or do. Use it to check your explanation. If something is unclear, explain it differently and check again. People may refer to their handout. [1]

Original wording for these tools: “I want to check that I've explained this clearly. Using your sheet, what will you do next, and who will you contact if that doesn't work?” Avoid turning the conversation into a score or a test of the person.

Make the take-away usable

  1. Let the person choose what belongs on their copy and who, if anyone, they want to share it with. Keep any required clinical documentation in your established workflow.
  2. For paper, print only the useful sheet. For the fillable PDF, save a completed copy on the person's chosen device and reopen it to confirm the notes are there.
  3. For the web editor, use “Save my notes as text” or print before leaving. Notes are not saved automatically. Check that the person can find the file again. Use your organization's procedures for shared computers and downloads.
  4. Name the unresolved question, the person taking the next action, and when to check back. A completed sheet does not prove that an appointment, service or ride is available.

Learn whether the sheet helps

Run separate patient/family and provider-staff usability sessions using fictional details.

For an initial usability pilot, observe whether a person can choose the right sheet, record a usable contact or appointment, identify what remains unconfirmed, and retrieve the saved or printed copy. Ask what felt confusing, unnecessary or missing. Use fictional details during demonstrations and collect only the feedback needed to improve the tool.

These are proposed usability observations, not validated clinical measures. Downloads and completed forms do not establish better attendance, reduced relapse or improved health. Those outcomes require a separate evaluation.

Scope and sources

This is an original facilitation guide for two practical organizers. Review it against your service's population and workflow before use. It does not provide assessment, medication, emergency-care, consent or legal-compliance instructions.

  1. AHRQ: Use the Teach-Back Method, Tool 5. General communication method. The example scripts here are original adaptations.
  2. NIAAA: Questions for Alcohol Treatment Programs. Alcohol-treatment context, including schedules and expectations.
  3. SAMHSA: How to Ask for Help. Specific support requests and chosen contacts. The maintained support-map source capture is reused.