Free printable CHC evidence checklist
In short: A free checklist to print. Use it to gather evidence before a CHC assessment.
In short
- Print this page, or save it as a PDF from your browser.
- Tick each item as you get it.
- Write notes under each of the 12 areas.
NHS Continuing Healthcare guide: Start here · Checklist, assessment and the 12 areas · Evidence and appeals · Should I pay a firm? · Free printable checklist
Papers to ask for
- ☐ Copy of the CHC Checklist
- ☐ Copy of the completed Decision Support Tool (DST)
- ☐ The decision letter, with reasons
- ☐ Care home or home care notes and charts
- ☐ GP, hospital and nurse records
- ☐ Letters from professionals who know the person
- ☐ A daily diary (at least 2 weeks, day and night)
- ☐ Proof of who can act (Lasting Power of Attorney, or executor papers)
Notes for each area
For each one, write: what happens, how often, how long help takes, and what goes wrong if help is late.
- Breathing: ____________________
- Nutrition: ____________________
- Continence: ____________________
- Skin: ____________________
- Mobility: ____________________
- Communication: ____________________
- Psychological and emotional needs: ____________________
- Cognition: ____________________
- Behaviour: ____________________
- Drug therapies and medicine: ____________________
- Altered states of consciousness: ____________________
- Other significant care needs: ____________________
Key dates
- Date of decision letter: ________ (time limit in letter: ________; guidance says within 6 months)
- Date of local resolution letter: ________ (time limit in letter: ________; guidance says within 6 months)
Information only. This page explains official guidance in plain English. It is not legal or medical advice. Rules can change. For advice about your own case, contact Citizens Advice or another free adviser.
Where this applies: England. Scotland, Wales and Northern Ireland have different rules.
Written by Social Care Made Easy. Last checked: 25 October 2026.