HLAB Family Intake

A DJ@HLS project

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Please indicate the date (if any) that the PCL has received the following notices. Leave blank if not applicable.

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Please provide the following information about each defective condition in the apartment.

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Please ask for the following contact information from PCL.

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Enter the PCL’s name, address, phone number, birth date, racial or ethnic identity, and language skills as a CONTACT in TM. Use “PotentialCLNT” as the code.

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If Client is not safe, please provide them the following information.

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What is the PCL's date of birth?

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PART II: DEMOGRAPHIC INFORMATION

Optional Script: I’m now going to ask you a series of optional questions. Please feel free not to respond. (If using this script, please be sure to signal when the optional questions are over. See below.)

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Has tenant ever been without heat or hot water?

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Please provide the following information about each time you went without heat or hot water.

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How was PCL referred to HLAB?

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Please provide the following information about each defective condition in the apartment.

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Please provide the following information about each defective condition in the apartment.

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Are there any upcoming deadlines (including court dates)?

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When is the nearest deadline?

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Great - it looks like PCL is income eligible.

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Please provide the following information about each defective condition in the apartment.

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How did PCL hear about HLAB?

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PART III: FINANCIAL ELIGIBILITY

(optional script) Thank you for answering these optional questions, I'm now going to ask you financial questions to determine eligibility.

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Non Payment and Cause follow up questions.

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Do you think the intake interviewer could benefit from Chris Pierce's expertise?

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Part IV
DETAILS KEY QUESTIONS

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PCL appears to be over income. You can continue if you think this is incorrect.

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PCL has too much retirement

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What is PCL's primary language?

  • English
  • Spanish
  • Haitian Creole
  • Korean
  • Mandarin
  • Cantonese
  • Portuguese
  • German
  • French
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Write the interview appointment in the intake binder.

T189

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Please provide the following information about each time you went without heat or hot water.

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DOWNLOAD

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Thanks for using the INTAKE TOOL. You should be all set.

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Please ask about a first adult in household

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What is the caller asking HLAB to do?

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What is the PCL's address?

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We cannot conduct an intake with a PCL that poses a conflict of interest. Please REFER OUT PCL.

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Check Time Matters for a conflict of interest.

Does PCL pass the conflict check?

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What is a safe number to contact the PCL?

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PART I: PERSONAL AND CONTACT INFORMATION

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What is the PCL's full name?

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Welcome to the HLAB Family Intake Program.

You can pause and resume the tool by clicking the button in the top right labeled Pause and entering in an email address.

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What is your name (Law Student Name)?

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Where does OP currently live?

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Please provide the following information about each defective condition in the apartment.

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Please select all (if any) benefits your client currently receives.

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What is the PCL's weekly net income?

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Clients are automatically eligible (financially) if they receive TAFDC, EAEDC, SSI, or WIC.

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Are there any other income earning adults in the household?

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What are the total non retirement liquid assets and total non liquid assets?

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What is the total number of individuals in the household?

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Please provide the following information about each defective condition in the apartment.

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Does tenant have any other defective conditions in the apartment?

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Please ask the PCL about the landlord and their attorney?

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What is the OP's full name?

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Last Month Rent

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The following questions are optional.

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NB: We are not likely to take this kind of case.

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Security Deposit

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In which courthouse is the case taking place?

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What is PCL's martial status?

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Please provide more information on disability.

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Filings

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Please provide the following information about each time you did not have heat or hot water.

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What was the last city PCL and OP last lived together?

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Schedule the interviewer for a room at the designated time in TM, taking care to leave an hour free between interviews whenever possible. Write ‘Intake’ in the “Regarding” box and use HLAB-General as the client.

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Write the interviewer’s name on the back of the phone intake form. [T199]

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Please provide the following information about each time you went without heat or hot water.

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We still need to schedule our meeting with our client. What day of the week works best for our client?

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Check for conflicts in TM by searching for the PCL’s and OP’s name in “Contacts.”

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Please provide the following information about each time you did not have heat or hot water.

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Please ask about a first adult in household

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Please provide the following information about each time you did not have heat or hot water.

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Looks like the PCL is outside our geographic eligibility. If you think this is a mistake, you may continue anyway.

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Your Documents