ANNUAL SUMMARY/3rd QUARTER	Date
Client	Meeting Date with Client
Staff	Meeting Date with WSC
Services	SLC	PS-Day	PS-Qtr	LSD1	Other (specify)
Months Covered	Qtr 3/AR
Write the date (dd-mm-yy), names, meeting dates, check the services the individual receives, and write the months covered for the review. Complete the Person-Centered Planning, using that information to complete the client's planned/projected goals and an action plan for accomplishing each goal for his new support plan year. The Annual Summary, Quarterly Summary, and other documents from the Checklist are provided to the WSC in the 3rd Quarter and make up the total Annual Report. * The 3rd Quarter Annual Summary covers the first 9 months of the current support plan and the 4th quarter of the previous support plan.
PROJECTED GOALS: Write the client's planned/projected goals from his Person-Centered Planning for his new support plan year, numbering each goal and showing the service responsible for each goal.

CURRENT GOALS: Write the client's current goals (from the SP or as changed), numbering each and showing the service responsible for each goal.

ANNUAL SUMMARY: Write a summary of activities and progress the client has made on his current goals during the 1st, 2nd, and 3rd Quarters (the first 9 months of the SP). Include the 4th Quarter Summary of activities and progress made on goals during the previous 4th Quarter (the last 3 months of the previous SP). Progress summary should include what the client did to accomplish each goal (Performance), what staff did to assist him to achieve his goals (Strategies), how often staff helped with goals (Frequency), whether the client was successful and satisfied with his progress, and the results of his training (Assessment). Include his future plan for what's next.

Individual	Signature	Date
Client
Guardian
Staff
WSC