Conduct an intake interview with your client using the skills learned in class. Conduct informed consent procedures including confidentiality, do an assessment and look for strengths.

Create an organized document with the following information:

• Agency Name
• Mission Statement of your Agency
• Population Served
• Eligibility Requirements
• Demographic information for your made-up client (name, age, address, phone number)
• Referral source and reason for referral
• Document how you conducted informed consent procedures including confidentiality
• Strengths Assessment
• Intake Summary
o Workers name, date of contact, date of summary
o Sources of information during the intake interview
o Presenting problem
o Summary of background and social history related to the problem
o Diagnostic summary statement (pinpoint the issue that needs to be addressed)
o Treatment recommendations (what services can your agency offer to help this
person?)  

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