This is the "Project HAIRE GC additional" template. It should be called in the following format:

{{Project HAIRE GC additional
|Gender=
|Age=
|Place Transport=
|Place Transport notes=
|Place Streets=
|Place Streets notes=
|Place Facilities=
|Place Facilities notes=
|Place Healthcare=
|Place Healthcare notes=
|Place Support=
|Place Support notes=
|Place Skills=
|Place Skills notes=
|Place Social=
|Place Social notes=
|Place Governance=
|Place Governance notes=
|Person Physical=
|Person Physical notes=
|Person Emotional=
|Person Emotional notes=
|Person Mobility =
|Person Mobility notes=
|Person Family=
|Person Family notes=
|Person Identity=
|Person Identity notes=
|Person Finances=
|Person Finances notes=
|Person Skills=
|Person Skills notes=
|Person Future=
|Person Future notes=
|Empowerment Local=
|Empowerment Local notes=
|Empowerment Control=
|Empowerment Control notes=
|Empowerment Personal=
|Empowerment Personal notes=
|Empowerment Inclusion=
|Empowerment Inclusion notes=
|Wellbeing Future=
|Wellbeing Mind=
|Wellbeing People=
|Wellbeing Problems=
|Wellbeing Relaxed=
|Wellbeing Thinking=
|Wellbeing Useful=
}}

Edit the page to see the template text.