This form is to be filled out by the CARE Coordinator or Freedom Project Staff. This is not meant to be filled out by the person receiving support.
Freedom Project supports "informal intakes" - all of these questions don’t need to be answered in order to submit this form. Please just provide the information that you have available to you. You can always come back and include more information at a later point.
There are a few things we DO need though - a name (can be a nickname without a last name, as long as you use the same name when entering in more information about this person) You will also have to at least indicate which CARE Coordinator will be working with this person, which "project" the person is eligible for, and what "touch level" this person needs in their support.
If this person qualifies for a particular program (such as Credible Allies, which serves Black, Indigenous, and People of Color under age 30 with a connection to Seattle), please provide the demographic information that qualifies them for that program (such as birthdate, race, or zipcode), so that we can have the data needed to include them for those grant reports.
Provide details here on the specific needs of the individual, if needed or relevant.
If you do not have this information yet, please use the CARE Coordinator report form to provide updated information or contact Felicia/Champion regarding next steps for this individual.
Please follow up with case information through the CARE Coordinator report form or contact Felicia/Champion regarding next steps for this individual.