PLEASE FOLLOW THE TEMPLATE DONT WRITE IN PARAGRAPHS, USE TABLES

USE RANDOM VALUE, IN CONTEXT TO WORKPLACE PLACEMENT TRAINING

ASSESSMENT FORM- CLIENT A

CLIENT PARTICULARS

Name:

Name of Case Manager:

Date of Assessment:

Presenting Concerns

Past Medical History and Background

Previous Agency Involvements

Psychosocial and Behavioural Health

Psychosocial Support Systems

Risk Assessment

Need for Short-term and Long-term Support

Strengths

Weaknesses

Goals

ASSESSMENT FORM- CLIENT B

CLIENT PARTICULARS

Name:

Name of Case Manager:

Date of Assessment:

Presenting Concerns

Past Medical History and Background

Previous Agency Involvements

Psychosocial and Behavioural Health

Psychosocial Support Systems

Risk Assessment

Need for Short-term and Long-term Support

Strengths

Weaknesses

Goals

ACTION PLAN- Client A
Name of Client:	Date of Assessment
Issues Guidance: The issues and goals recorded should reflect the words and sentiments of the client. It should include risk or potential risk to the client.	Goal Guidance: The goals should be measurable so that you, as the case manager, and the client will know when they have been achieved or need to be reevaluated.	Plan/Strategy Guidance: There may be more than one activity for each issue/goal.	Person/Service Responsible Guidance: The responsible person may include you, other service organisations, the client's family/caregiver, and other formal/informal support. The client receiving support should be given appropriate responsibility in implementing and pursuing their plan.	Target Date Guidance: The time frame (target date) should be appropriate and specific to the issue, goal, plan/strategy (i.e., exact date should be provided).

ACTION PLAN- Client B
Name of Client:	Date of Assessment
Issues Guidance: The issues and goals recorded should reflect the words and sentiments of the client. It should include risk or potential risk to the client.	Goal Guidance: The goals should be measurable so that you, as the case manager, and the client will know when they have been achieved or need to be reevaluated.	Plan/Strategy Guidance: There may be more than one activity for each issue/goal.	Person/Service Responsible Guidance: The responsible person may include you, other service organisations, the client's family/caregiver, and other formal/informal support. The client receiving support should be given appropriate responsibility in implementing and pursuing their plan.	Target Date Guidance: The time frame (target date) should be appropriate and specific to the issue, goal, plan/strategy (i.e., exact date should be provided).

Steps to take:

1. Review your organisation's policies and procedures for completing an intake interview for clients. Guidance: These may have already been provided to you on your first day of vocational placement or during your induction and orientation in the service.

2. Request for your supervisor's authorisation to access the referral form or the details of the client. Review the client's details before proceeding with the intake interview.

3. Follow your organisation's policy and procedure for completing the intake interview. Ensure that you have:

a. Introduced yourself and the service and sought introduction from the client.

b. Engaged the client by establishing rapport and trust.

c. Identified the purpose of the interview, oriented the client, and sought the client's participation.

d. Ensured that the client is empowered and their independence is maintained.

e. Explored the most urgent issues/ risk or potential risk the client is experiencing and prioritised these with the client.

o Developed an action plan with the client that contains the following:

- Most urgent needs of the client (at least three)

- Desired result/goal for each need

- Activities/strategies that will be used to pursue each goal with a person

-centred approach

- Responsible person/s who or service/s that will carry out each activity/strategy

- Timeframe for the activities/strategies

4. You may use your organisation's forms to document the intake interview, or you may locate the following templates below:

o Assessment Form

o Action Plan