Case Plans - THP

							Case Plans - THP
Complete for heads of household and single clients only.


1. Client Name ____________________________________                   ServicePoint ID: ________________________


2. Program (same as program specified in client’s entry/exit): ________________________________


3. Include all household members?  Yes            No—Exclude: _________________________________


4. Date goal was set (exit date from program): _____ /_____/ ______
                                             Month     Day      Year



5. Goal classification: Housing (select for THP) Type: Maintain permanent housing


6. Target date (6 months after exit date): _____ /_____/ _____
                                            Month     Day     Year


7. Overall status of goal:  Identified            In Progress               Closed


8. Did you attempt to contact the client to follow up on case plans?  Yes             No

If yes: a. Projected follow-up date (6 months after exit date): _____ /_____/ ______
                                                                        Month   Day     Year
        b. Actual follow-up date: _____ /_____/ ______
                                   Month    Day     Year

        c. What was the status of the client’s THP housing goal at follow-up?

         Achieved               Not achieved               Unknown—unable to contact client




Wilder Research                                              1 of 1                                       Updated 1/2009