What does a hospital passport include?

A hospital passport can include communication needs, health information, what matters to the person, important contacts, and reasonable adjustments that help during care.

Can a carer complete a health passport?

Yes. A carer, family member, or support worker can help complete the health passport so the summary reflects the person clearly and accurately.

How do clinicians use a health passport?

Clinicians can use a health passport as a quick one-page reference before or during appointments, admissions, and discharge planning.

Is this useful for autism and other communication needs?

Yes. The health passport is designed to help people share communication needs, sensory considerations, routines, and reasonable adjustments in a practical format.

Health Passport

by Know Me

Share with healthcare professionals to communicate your needs and reasonable adjustments

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Prefer a paper version?

Download a blank Know Me template to print and write.

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Choose an Image Style

Realistic

Illustrated

Easy on the i

No Images

Do you have a learning disability or autism? Required

Please choose at least one. This helps services give you the right support.

Learning disability

Autism

Neither

My name is Required

The name I like new people I meet to use Required

How I like to be contacted Required

Please choose at least one.

Phone call

Text

Through someone else

Your address

Your postcode

We use your postcode to show local support and to add it to your passport. You can skip this.

About Me

My date of birth is

Day

Month

Year

My NHS number

My religion, culture or beliefs

My gender is

My pronouns

What is your preferred language?

My nationality

The people important to me are

These are example options. Select the ones that are right for you.

Family

Support staff

Friends

Other Caregivers

Social Worker

Add your own

This passport has been completed by

Things I like to talk about

My Health

My health conditions and diagnoses

My mental health

My allergies are

Do I take regular medicines?

My Needs

How I communicate and what support helps

These are example options. Select the ones that are right for you.

How I communicate pain

These are example options. Select the ones that are right for you.

I cannot use standard pain scales

I mask pain

I tolerate severe pain for a long time

I become distressed when I am in pain

I need information shared with me in this way

These are example options. Select the ones that are right for you.

Easy Read

Written down

Email summary

Pictures

Symbols

Add your own

When communicating, these reasonable adjustments will help me

These are example options. Select the ones that are right for you.

Please talk slowly and clearly

Please give me time to respond

Talk me through procedures slowly, step by step

Please write down the key points I need to remember

Give clear instructions with time frames

Use a now and next approach

Keep me updated if things change

Add your own

How do you mobilise?

Independently

With support

My eating, drinking and dietary needs

List any dietary requirements, food preferences or speech and language advice

These are example options. Select the ones that are right for you.

Peg or tube fed

I have a plan from a healthcare professional

I need adapted cutlery or plates

I have restricted foods

I like to eat in private

How do you manage your oral hygiene?

Reasonable adjustments I need to access healthcare

Select the adjustments you need. More choices will appear below where you can add detail.

Longer appointments

Minimal waiting time

Quiet waiting area

Side room

Step-free or wheelchair access

Add your own

Things that might lead to sensory overload/overwhelm in a healthcare setting are

These are example options. Select the ones that are right for you.

I do not know what is happening

The place is busy

It is too loud

I am made to wait

The lights are too bright

Add your own

If I am overwhelmed in a healthcare setting I might

These are example options. Select the ones that are right for you.

Cry or shout

Self Stimulate

Withdraw or go silent

Meltdown or shutdown

Leave the department or ward and I may not tell you

Add your own

Items that help me manage my sensory needs are

These are example options. Select the ones that are right for you.

Weighted blanket

Sunglasses

Ear defenders

Headphones

Add your own

Things you can do to help me when I’m feeling overwhelmed

These are example options. Select the ones that are right for you.

Give me time to settle

Reduce noise and activity

Dim the lights

Take me to a quieter area

Hold my hand

Reassure me

Leave me alone for an agreed time

Add your own

How to help me during tests or medical procedures

These are example options. Select the ones that are right for you.

Distraction

VR headset

iPad or tablet

Music

Small talk

Silence

Step by step guide

Add your own

Have you ever had a blood test?

Is there anything else a healthcare professional should know about you so they can support you better?

These are example options. Select the ones that are right for you.

Lasting Power of Attorney (LPA)

ReSPECT form

Advance Decision to Refuse Treatment

Communication or behavioural plan

Add your own

Send your passport

Email address

Add your email address to receive your health passport Required

Tick this box to get emails from Know Me, like a reminder to update your health passport. You can stop these emails at any time.