Client Intake Packet

1. Client Intake Packet:

For individuals and families seeking support, resources, and navigation assistance. The Client Intake Packet helps Second Family Circle better understand your needs, current situation, and the type of support or resources you may be seeking. The information you provide helps us connect you with appropriate support options, referral information, and community resources.

2. Individual, Family & Household Information:

This section collects basic contact information, household details, emergency contact information, children or family information when applicable, and your preferred method of communication.

3. Support Needs, Goals & Current Situation:

This section allows you to share what kind of support you are looking for. This may include help with housing, food, transportation, employment, education, mental health resources, legal resources, reunification support, reentry support, or other basic needs.

4. Confidentiality, ROI & Service Coordination:

Information shared with Second Family Circle is handled with care and respect. A Release of Information form may be completed when you would like Second Family Circle to communicate with approved providers, agencies, organizations, or other contacts on your behalf.

Download, Complete & Email the Form. Please download the intake packet and complete the necessary sections to the best of your ability. Once completed, email the form to info@secondfamilycircle.org.

Information shared is used to provide support, referral information, and resource navigation. Confidentiality may have limits when safety is at risk, when required by law, or when a signed Release of Information allows communication.