Nonprofit Client Intake Form Template for United States

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Key Requirements PROMPT example:

Nonprofit Client Intake Form

"Need a Nonprofit Client Intake Form for our homeless shelter that includes detailed income verification sections and mental health screening questions, compliant with California state regulations and HIPAA requirements for implementation by March 2025."

Document background

The Nonprofit Client Intake Form serves as the primary documentation tool for establishing client relationships and determining service eligibility within nonprofit organizations. This document is essential for maintaining compliance with U.S. federal and state regulations while gathering necessary information to provide appropriate services. It includes sections for personal information, service needs, consent forms, and eligibility documentation, helping organizations maintain proper records for both service delivery and regulatory requirements.

Suggested Sections

1. Client Information: Basic demographic and contact information for the client including name, address, phone, email, and preferred contact method

2. Service Requirements: Detailed information about specific needs and services requested by the client

3. Eligibility Criteria: Documentation and verification of client's qualification for services including any relevant income, residency, or needs-based criteria

4. Privacy Notice: Comprehensive information about how client data will be collected, used, stored, and protected in compliance with federal and state privacy laws

5. Consent Section: Client authorizations, acknowledgments, and signatures for service provision and data handling

Optional Sections

1. Income Verification: Documentation and verification of client's income status, required only for income-based services or sliding scale fee structures

2. Medical Information: Health-related information and history, including current medications and conditions, required only for health-related services

3. Emergency Contacts: Alternative contact information and authorized representatives, recommended for ongoing or crisis services

Suggested Schedules

1. Required Documentation Checklist: Comprehensive list of documents needed to complete the intake process

2. Program Guidelines: Detailed information about available services, eligibility requirements, and program policies

3. Client Rights and Responsibilities: Detailed explanation of client rights, responsibilities, and mutual obligations in service provision

4. Release of Information Forms: Standard authorization forms for sharing information with specific third parties or for specific purposes

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Social Services
Healthcare
Education
Housing
Food Security

Relevant Teams

Client Services
Compliance
Operations
Legal
Data Management

Relevant Roles

Program Director
Case Manager
Intake Coordinator
Compliance Officer
Social Worker

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Electronic Intake Forms

Legal framework for electronic intake forms compliant with US federal and state regulations, governing digital information collection and processing.

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Let's create your Nonprofit Client Intake Form

Authors

Alex Denne

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