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Supported Decision-Making Agreement Tool

Use this tool to create your own Supported Decision-Making Agreement. To get an idea of what your agreement will look like, see our Sample Agreement. To learn more about this topic, see Making My Own Choices: An Easy-to-Follow Guide on Supported Decision-Making Agreements.


To create your Supported Decision-Making Agreement, follow these steps:

  1. Complete the form below

  2. Click the button at the bottom of this page

  3. Download and print the PDF of your agreement

  4. You and your supporter(s) sign the agreement in front of two witnesses or a notary public, who also sign the agreement

  5. Keep your signed agreement in your files


If the options in this tool don't cover your specific situation, begin the intake process to apply for our services and get help creating your Supported Decision-Making Agreement.


Please note that a person can only enter into a Supported Decision-Making Agreement if they have the capacity to do so. This means that the person must be able to understand and explain the following:

  • What a Supported Decision-Making Agreement is

  • What types of decisions their supporter will assist them in making

  • That they will be the one making the decisions and not the supporter

  • That they can revoke the Supported Decision-Making Agreement at any time


Languages: this Supported Decision-Making Agreement generator is available in English and Spanish. Be aware that DRTx recommends that you provide the document in a language understandable to the party or entity receiving it, which in most circumstances will be English. This will better ensure the agreement is honored and followed as directed in the document.

Form

"*" indicates required fields

Enter the first and last name of the adult with a disability.

Enter the email address of the adult with a disability. If you enter your email address, a copy of your Supported Decision-Making Agreement will be emailed to you. If you don't have an email address, leave this field blank.

Wha will your supporter(s) help with?

Your supporter(s) can help you with life decisions. Check the life decisions below that your supporter(s) can help you with.

Health information
Yes
No

Do you want your supporter(s) to see your private health information?

Education records
Yes
No

Do you want your supporter(s) to see your educational records?

End date
Month
Day
Year

When would you like your Supported Decision-Making Agreement to end? If you don't enter a specific date, your agreement will include an end date 10 years from now. Also, you and/or your supporter(s) can end the agreement at any time.

Your Supported Decision-Making Agreement will automatically be emailed to the email addresses included above. If there is another person who should know about the agreement, enter their email address below and they will receive an unsigned copy of it. You can only enter one email address. You can also send the agreement you download and/or receive via email to others. If there isn't anyone else you want to share your agreement with, just leave this field blank.

Additional Information

The optional questions below are for the adult with a disability who is entering into a Supported Decision-Making Agreement. Thank you for answering these questions to help us ensure we reach a diverse group of Ohioans with disabilities.

Please slect the gender you identify with
Male
Female
Other
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to say
Other
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
Prefer not to say
Are you a veteran?
Yes
No

What is the total income for your household in one year?

How many people are in your household?

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