Mobility and Transfer Record

Who this is for

A record of how someone moves, written from the assessment they were given. For each activity it takes what the person does themselves, what equipment is used, how many people help and what the assessor wrote — and underneath, a dated record of any change and who was told.

Carers and families following an assessment made by a physiotherapist, occupational therapist or moving and handling assessor, agencies keeping a copy in the home, and anyone who needs a new carer to know on day one how the person gets from bed to chair.

What this helps you track

• What the person can do for themselves, activity by activity
• The equipment named in the assessment and where it is kept
• How many people the assessment says are involved in each move
• What the assessor wrote, copied across in their words
• Changes noticed since, with the date and who was told

How to use it

1. Write the person's name, who did the assessment, their role and the date it was made at the top.
2. For each activity in the first table, copy in what the assessment says: what the person does themselves, what equipment is used and how many people help.
3. Add the notes the assessor gave you in their words, and where the equipment is kept.
4. When something changes — the person can do more, or less, or the equipment is different — add a dated line to the second table and report it to whoever the care plan names.
5. Keep the sheet with the assessment it was written from, and replace it when a new assessment is made.
6. Fill it in on paper, or online and save it in your own browser.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does the sheet tell me how to move someone?

No. It contains no technique, no method and no limit of any kind. Everything in it is copied from the assessment the person was given, and the person who made that assessment is the one to ask about how a move is done.

Can I fill it in without an assessment?

The record is built to hold what an assessment says. Without one, write what the person tells you about how they move and say so plainly at the top, and ask whoever arranged the care about an assessment.

What counts as a change worth recording?

Anything different from what the assessment describes: a move that has become harder or easier, equipment that has changed, a near miss. Write it down with the date and who you told; the sheet does not decide what it means.

Why record how many people help?

Because a new carer arriving alone needs to know at once whether that is how the move is meant to be done. The figure is the one in the assessment, not one of ours.