Follow On
comprehensive continuity plan
BASIC CONTINUITY PLAN
Personal & Professional Information
Full Legal Name
Preferred Name (if different)
Email Address
Phone Number
State of Residence
State of Residence
England
Scotland
Wales
Northern Ireland
Profession / License Type
State(s) of Licensure
Practice Type
Solo practice
Group practice
Organization / Institution
Existing Documents & Authority
01
Do you currently have any of the following?
Will
Power of Attorney
Continuity or Succession Plan
None
Where are these documents stored?
Who currently has access to these documents?
Client Impact & Practice Complexity
01
Approximate Number of Active Clients
1–25
26–75
76–150
150+
02
Average Client Engagement Duration
Less than 6 months
6–12 months
1–3 years
Ongoing
03
How is client data stored?
Physical records
Digital systems
Both
04
Systems Used (select all that apply)
EHR
CRM
Case management system
Other
Who currently has access to client data?
Successor & Continuity Structure
01
Have you identified a successor or responsible party?
Yes
No
Relationship to successor
02
Is a backup successor identified?
Yes
No
03
Successor Authority Type
Temporary authority
Permanent authority
Conditional authority
Activation & Risk Scenarios
01
Events that should activate this plan
Death
Incapacity
Disability
Emergency
Planned absence
Who is authorized to activate this plan?
02
Is verification required prior to activation?
Medical verification
Legal verification
No verification required
Durability & Long-Term Preferences
01
How often should this plan be reviewed?
Annually
Every 2 years
Upon major life or practice change
How should updates be documented?
02
If the successor becomes unavailable, what should occur?
Activate pre-authorized backup
Appoint a successor at time of need
Communication & Notifications
Who should be notified first upon activation?
01
Client Notification Preference
Immediate notification
Delayed notification
Only if legally required
02
Preferred Communication Method
Email
Phone
Written notice
Confirmation & Next Steps
01
Confirmation
I confirm that the information provided is accurate to the best of my knowledge.
02
Consent
I consent to the secure storage and review of this information for continuity planning purposes.
03
Follow-Up Contact
I would like to be contacted to schedule a review.
Schedule a Review
Previous
Next
