My Support Network

My Support Network Worksheet

Fill in each response. When you hit Submit, your answers will display on screen and you can download them as a PDF.

1. Who is the person I can most depend on?

2. What family do I have that is supportive?

3. What friends do I have who are supportive?

4. Who do I socialize with? Who do I talk to via phone/text? Who do I go places with?

5. Who is my primary care physician?

6. Who is my mental health provider?

7. Who is my cognitive strategies provider / speech therapist?

8. Who is my physical / occupational or fitness coach?

9. If working, who is my direct supervisor?

10. If in school, who is my academic advisor?

11. Who is my legal advisor?

12. Who is my spiritual advisor?

13. Who else is in my support circle?

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