WORKPLACE ADJUSTMENT PASSPORT

Name / preferred name: [Name]
Role / working context: [Details]
Preferred way to discuss support: [Method]
Last updated: [Date]

About my work
[Tasks, strengths and working preferences relevant to support.]

Barriers I experience
[Describe situations and work-related impacts. Include only personal information you choose to share and that is relevant.]

Support that helps
[Adjustment / how it helps / when it is needed.]

Current status
[Mark each item: requested, being discussed, agreed, in place, or awaiting review.]

People and actions
[Who is responsible / next action / agreed date.]

Communication and sharing
[Who needs which information / how I would like changes discussed.]

Review and changes
Next review: [Date agreed together]
Changes in role, location or manager to discuss: [Details]
What is working / what needs to change: [Notes]

This passport supports a conversation and a continuing record. It does not itself approve an adjustment or replace an adjustment plan.