Case Management Checklist Template
Streamline your case workflows and ensure nothing falls through the cracks with our comprehensive Case Management Checklist Template. Perfect for legal, social work, healthcare, and beyond, this template guides you through each critical step, promoting consistency, reducing errors, and improving case outcomes. Download now and elevate your case management efficiency!
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Case Intake & Assessment
Initial steps for receiving and evaluating a case.
Date of Initial Contact
Summary of Initial Client Presentation
Reason for Case Intake
Client Age
Primary Concerns Reported
Referring Agency (if applicable)
Initial Observations & Potential Risks
Client Information Verification
Confirming client identity and relevant details.
Full Name
Date of Birth (YYYY)
Address
Phone Number
Identification Type
Copy of Identification
Emergency Contact Name
Emergency Contact Phone
Needs Assessment & Goal Setting
Identifying client needs and establishing desired outcomes.
Client's Perceived Needs (in their own words)
Primary Areas of Need (select all that apply)
Client's Income (monthly)
Client's Strengths and Resources
Client's Level of Engagement
Initial Case Goals (collaboratively established)
Goal Review Date
Resource Identification & Allocation
Locating and assigning appropriate resources to support the case.
Primary Support Worker Assigned
Specialized Services Required
Estimated Budget Allocation
Supporting Documentation (e.g., referrals)
Referral Date
Transportation Resources
Service Delivery & Implementation
Executing planned interventions and providing services.
Service Delivery Start Date
Description of Services Provided
Number of Sessions Completed
Service Delivery Method
Supporting Documentation (e.g., Progress Notes)
Duration of each session
Progress Monitoring & Evaluation
Tracking progress, assessing effectiveness, and making adjustments.
Date of Progress Review
Progress Score (1-5)
Summary of Progress Made
Challenges Encountered & Solutions Implemented
Overall Assessment of Progress
Areas Requiring Further Attention
Notes from Stakeholder/Client Feedback (if applicable)
Date of Next Review
Documentation & Record Keeping
Ensuring accurate and complete case records are maintained.
Date of Record Creation
Summary of Initial Assessment Notes
Supporting Documentation (e.g., reports, correspondence)
Record Type
Detailed Actions Taken & Outcomes
Number of Pages in Attached Documents
Case Manager Signature
Record Identifier/Case Number
Communication & Collaboration
Facilitating communication with clients, stakeholders, and team members.
Last Client Contact Date
Contact Method (Phone, Email, In-Person)
Summary of Communication & Key Discussion Points
Stakeholders Involved in Communication
Topics Discussed
Next Communication Planned (Type)
Date of Next Communication
Risk Management & Safety
Identifying and mitigating potential risks to client safety and well-being.
Client’s Current Risk Level
Description of Identified Risks
Potential Risk Factors (Select all that apply)
Safety Plan Details
Next Safety Plan Review Date
Location of Potential Safety Concerns
Staff Signature (Acknowledging Risk Assessment)
Case Closure & Transition
Finalizing the case, ensuring a smooth transition, and documenting outcomes.
Case Closure Date
Summary of Case Outcomes & Progress
Client Satisfaction (Post-Closure)
Recommendations for Future Support (if applicable)
Referral to Other Services (if applicable)
Details of Referral (if applicable)
Case Manager Signature
Case Manager Name (Printed)
Case Management Screen Recording
See ChecklistGuro's Case Management in action! This screen recording demonstrates how our BPM platform simplifies case tracking, task assignment, and overall process control. Learn how to improve efficiency and reduce errors with ChecklistGuro. #CaseManagement #BPM #ChecklistGuro #ProcessAutomation #Workflow
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