All About Me - Harmonious Service Pairing Request 

***  Complete this form if you need a new provider or we are working with you to hire someone to meet your needs. 

Annual Review, We need to check in once a year on the paperwork side of things, make sure you have mandated forms, etc. 

Intake, Terms of Use. Welcome!

Release of Information, For if you want us to be able to share information back and forth. The intake automatically includes a few people but this form is for specifics. 

Basic Life Review with Safety Assessment

*** This is a detailed document that reviews the basic areas of life. This is what we complete with individuals who we support in a comprehensive extended family sort of way for IRSS services and we encourage all families to work their way through this and review it annually for themselves. When you complete this do it in a two step fashion. Step one, complete it with basic information, this will get an outline written down for you as well as introduce you to the tool. Step two, go back through it slowly and complete each section as though this was the only tool someone had to help the person you love and you were not available to guide them or answer questions. You can also do this for yourself in case you ever need help the person helping you would know what is important. 

5 Wishes

5 wishes is an advanced directive booklet that helps you plan for the worst case scenarios in life. If you want a copy please reach out to us an let us know. 

ENVIRONMENTAL REVIEW: Community Form, If you want us to explore a new community space complete this. This can be for your family or a location you just think we should know about. 

Service Review 

Concern / Praise


Medical Visit Form for Providers and Clients to Use Together > A requirement for Residential Clients

Health Form with Proxy and Specific Medications

Standing Order for Individual for Over the Counter Medications

Physicians Order for Medication