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  • I. Clients Identifying Information

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    charizza mae ganaden
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    This document is an intake sheet for a client seeking financial assistance from the Provincial Social Welfare and Development Office in La Union, Philippines. It collects identifying information about the client and beneficiary, including names, addresses, ages, education levels and income. It also documents the client's family composition. The caseworker assesses the problems presented and recommends services, which include financial assistance, counseling or referral. For this client, financial assistance and others/burial are recommended. The recommended amount of financial assistance to extend is also documented.

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    GIS.docx

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    This document is an intake sheet for a client seeking financial assistance from the Provincial Social Welfare and Development Office in La Union, Philippines. It collects identifying information about the client and beneficiary, including names, addresses, ages, education levels and income. It also documents the client's family composition. The caseworker assesses the problems presented and recommends services, which include financial assistance, counseling or referral. For this client, financial assistance and others/burial are recommended. The recommended amount of financial assistance to extend is also documented.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    14 views2 pages

    I. Clients Identifying Information

    Uploaded by

    charizza mae ganaden
    This document is an intake sheet for a client seeking financial assistance from the Provincial Social Welfare and Development Office in La Union, Philippines. It collects identifying information about the client and beneficiary, including names, addresses, ages, education levels and income. It also documents the client's family composition. The caseworker assesses the problems presented and recommends services, which include financial assistance, counseling or referral. For this client, financial assistance and others/burial are recommended. The recommended amount of financial assistance to extend is also documented.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
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    General Intake Sheet

    Republic of the Philippines


    Province of La Union Financial Assistance
    Provincial Social Welfare and Development Office July 29, 2019

    I. CLIENTS IDENTIFYING INFORMATION

    Last Name First Name Middle Name Ext (Jr, Sr) Sex

    Present Address (No./Street/Purok, District, Barangay,Region, City/Municipality,Province,) Age

    Contact Number:
    Relationship to Beneficiary Civil Status

    Highest Educational Attainment Skills/Occupation Est. Monthly Income

    II. BENEFICIARY IDENTIFYING INFORMATION

    Last Name First Name Middle Name Ext (Jr, Sr) Sex

    Present Address (No./Street/Purok, District, Barangay,Region, City/Municipality,Province,) Age

    III. BENEFICIARY FAMILY COMPOSITION


    CIV
    HIGHEST
    S IL SKILLS/
    RELATIONSH EDUCATIONA EST. MONTHLY
    FULL NAME E AGE ST OCCUPATIO
    IP L INCOME
    X AT N
    ATTAINMENT
    US

    IV. ASSESSMENT
    PROBLEM(S) PRESENTED WORKERS ASSESSMENT

    RECOMMENDED SERVICES AND ASSISTANCE


    1
    PSWDO-002-0
    General Intake Sheet
    Republic of the Philippines
    Province of La Union Financial Assistance
    Provincial Social Welfare and Development Office July 29, 2019

    Nature of Service / Assistance

    FINANCIAL ASSISTANCE x COUNSELING REFERRAL

    Medical

    Food Subsidy (relief goods)

    4 Others/Burial

    V. RECOMMENDED AMOUNT OF FINANCIAL ASSISTANCE TO BE EXTENDED

    2
    PSWDO-002-0

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