Community Orientation Checklist

Goodwill
Industries of Wayne and Holmes Counties, Inc.

Community Orientation Checklist
Client Name*
Orientation Checklist to be completed by Case Manager and Client

ApplicationClient DatasheetClient Receipt of Policies and ProceduresClient Manual Provided to ClientConsent FormEmergency ContactModel ReleaseParticipant Involvement & Informed ChoiceTransportation AcknowledgementWorksite Agreement Form
Client Signature*

Clear
Program Start Date*

MonthDayYear
Date
Case Manager Signature*

Clear
Orientation Checklist to be completed by Administrator

Client DatasheetConsent FormClient Receipt of Policies andProceduresEmergency Contact FormModel ReleaseParticipant Involvement &Informed ChoiceTransportation AcknowledgementPolicyWorksite Agreement
Should be Empty: