Social Services Client Follow-Up Form

Social Services Client Follow-Up Form — Form Fields

This nonprofit template includes 10 fields. Check in with clients receiving nonprofit social services to assess progress and update needs. Free to customize and use on ZenBuild.

• Client Name (text, required)
• Case Worker Name (text, required)
• Case Worker Email (email, required)
• Follow-Up Date (text, required)
• Program Enrolled In (dropdown selection, required) — options: Housing Assistance, Food Security, Employment Support, Mental Health, Childcare, Education, Other
• Overall progress toward goals (rating, required)
• Updates since last check-in (long text, required)
• Barriers to Progress (checkboxes, optional) — options: Transportation, Childcare, Employment, Housing Instability, Mental Health, Medical, Financial
• Next steps and action items (long text, required)
• Is continued case management needed? (multiple choice, required) — options: Yes, No, Refer to another service