Seeking an intake form for the social science/services field, which may be employed to assess client needs. Additionally, any new instrument for conducting community assessments that can determine services needs.
The intake form should be modified as per the context of service and exposure of the community to that service/experience. I believe format can be taken but inputs should be specific.
Hennepin County https://www.icarol.info/ResourceView2.aspx?org=78732&agencynum=36898856 offers many social services and would have 1 or more intake screening forms. Homeless shelters such as Adult Shelter Connect https://www.simpsonhousing.org/our-programs/need-help/ , Hope Street Shelter https://www.cctwincities.org/hopestreet/ , or People Serving People https://www.peopleservingpeople.org/ would likely have forms that they use.