ASH NAZG DURBATULÛKThree systems for case notes under the sky, Some for the HMIS lords in their halls of stone, Lost paper files from trees doomed to die, One for Ash Nazg, built without skin or bone, For Family Promise, making shadows fly. One page to rule them all, One link to find them, One intake to bring them all, and in the brightness serve them.

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Client Progress Update

Please fill out this form to update your Case Manager.

Enter your phone number or ID #, or personal email

To locate your record, please enter one of the contact methods you originally provided:

Your Mobile Phone Number
Your Personal Email Address
Your Family Promise ID (Enter 555 + your birthdate MMDDYYYY)

What kind of update are you providing?

On-Going (every 2 weeks)

Change in Circumstances

On-Going Survey

In your work with your Case Manager, what have you found the most helpful?

in-person meetings

goal settings

budgeting/financial literacy

financial assistance, if any

case management with partner/spouse/kids

working with my landlord

advocacy on my behalf

What tools so far were the most useful?

Self-Sufficiency Matrix

Goal Setting

Resume Builder

Budget app

Night Shelter facility

Computer Lab

Day Center facility

Any additional notes?

Change in Circumstances

What is new about your situation?

Should answer to complete the following sentence (MUST CHECK AT LEAST ONE ADDITIONAL BOX, IF FILLING OUT "Other") Congratulations on…

getting a job

getting a pay increase

receiving benefits (DSHS/SSI/SSDI/Child Support/etc.)

being approved for housing

moving into new housing

preventing loss of housing

receiving financial assistance from a 3rd party/on-going support from another organization/etc.

moving in FPPC Night Shelter

moving out of FPPC Night Shelter

moving into a different shelter

If pay increase or benefit change, please list the changes below. N/A if not applicable

Housing Updates

If moving into housing, what type of housing is it?

Should answer to complete the following sentence (MUST CHECK AT LEAST ONE ADDITIONAL BOX, IF FILLING OUT "Other") Congratulations on…

moving with friends/family with no rent/support required

moving with friends/family and paying some sort of "rent"

moving into an apartment/house/room with rental agreement and Section 8 voucher

moving into an apartment/house/room with rental agreement with Rapid Rehousing or another type of on-going subsidy but no Section 8

moving into an apartment/house/room with rental agreement with no on-going subsidy

couch surfing/staying with friends/family temporarily

moving into a hotel paid by a client

moving into a hotel paid by an agency

moving into own by client house/mobile home

moving into own RV in a stationary spot

moving into own RV with no stationary spot

moving out of county/state

unknown

none of the above

place not meant for habitation (car, tent, etc.)

If leaving FPPC shelter, please provide reason

Completed Program

Non-compliance with program

Criminal activity/destruction of property/violence

Reached maximum time allowed by program

Needs could not be met by program

Disagreement with rules/persons

Death

Unknown/disappeared

N/A

Any additional notes?

Thank you so very much!