For
fields marked as drop-downs only one option can be recorded.
Time of
day and duration fields should have the data in HH:MM:SS format
For date fields, a complete date is needed, including the year, month and day
Name of Field |
Type of Field |
Notes |
Ethnicity |
Drop-down |
|
Employment Status |
Drop-down |
|
Family Size |
Number |
|
Education Completed |
Checkbox Group |
|
Family Income |
Drop-down |
|
Referral Source |
Checkbox Group |
|
Reason for Referral |
Text |
|
Referral Date |
Date |
|
Emergency Contact Name |
Text |
|
Emergency Contact Phone |
Text |
|
Emergency Contact Email |
Text |
|
Relationship to the contact |
Text |
|
Family Doctor |
Text |
|
Allergies |
Checkbox Group |
|
Relevant Medical Conditions |
Long Text |
|
For every call made into your helpline a record of this type is created. This means that for every call there should be one row of data in this tab with details of that call.
Name of Field |
Type of Field |
Notes |
Contact |
Contact |
Links to a Contact record. |
Date |
Date |
|
Call Start Time: |
Time of day |
|
Call End Time: |
Time of day |
|
Call Duration: |
Duration |
|
Reason for Contact |
Dropdown |
|
If Other: |
Text |
|
Notes/Comments |
Long Text |
|
Name of Field |
Type of Field |
Notes |
Date |
Date |
|
Client |
Contact |
Links to a Contact record. |
Reason for Referral: |
Checkbox Group |
|
Referral Type |
Checkbox Group |
|
Organization |
Contact |
Links to a Contact record. An organization that you might be referring your client to.
|
Internal Program |
Drop-down |
|
Unmet Needs |
Checkbox |
|
Remaining Needs |
Text |
|
Notes/Comments |
Long Text |
|
When you take on a new client, you might plan out how your organization will serve that client's needs. This record is to track every time you take on a new client or a previous client returns to avail themselves of your services. The information recorded here is not meant to record one instance of counselling, for example, but rather the client's intake and exit from a larger program that might include things like individual counselling sessions.
Name of Field |
Type of Field |
Notes |
Client Name |
Contact |
Links to a Contact record. |
Intake Date |
Date |
|
Program Name |
Drop-down |
|
Presenting Issues |
Long Text |
|
Relevant History |
Long Text |
|
Clinical Impressions |
Long Text |
|
Status |
Drop-down |
|
High-priority goals |
Long Text |
|
Objectives |
Long Text |
|
A timeline for treatment progress: |
Text |
|
Outcomes |
Long Text |
|
Exit Date |
Date |
|
Days in Program |
Number |
|
Reason for exit: |
Drop-down |
|
Notes/Comments |
Long Text |
|
Case Notes record is created for every instance of counselling or training received by a client, or every time they attend/participate in a program that you offer.
Name of Field |
Type of Field |
Notes |
Date |
Date |
|
Client |
Contact |
Links to a Contact record. |
Case Manager |
Contact |
Links to a Contact record. |
Program Name |
Drop-down |
|
Start Time |
Time of day |
|
End Time |
Time of day |
|
Duration |
Duration |
|
Updates and Progress Made: |
Long Text |
|
Homework: |
Long Text |
|
Desired Progress for the next meeting: |
Long Text |
|
Notes/Comments |
Long Text |
|
All drop-down menu and checkbox choice options will be customized to the data that you have sent.
If you have any additional fields of data that you would like to have in any of the above records, please send us a table like the one above detailing what the name of the field should be and what data type the field should have.