Internal Staff Documentation

Client Intake Process

Follow these steps to onboard a new client.

Quick Start: 3 Steps to Onboard

1

Phone Intake

Collect PHI & sign legal forms

Start Demographics
2

Before Visit

Client completes profile online

Client Profile
3

After Visit

Assessments + Care Plan

Generate Care Plan

Scroll for detailed form documentation

PHI Separation

How we protect client privacy

Part 1: Demographics

PHI

Contains identifiers (name, DOB, SSN, address). Staff collects via phone. Stored securely.

All Other Forms

Safe

Use Client Code only (SHC-YYMMDD-XXXX). No names or identifiers. Safe for AI processing.

Phase 1: Legal & Compliance

Client signs authorizations & consents. PHI Authorization must be first, Service Agreement must be last.

Authorization Acknowledgment Staff Only (PHI) Send to Client
1

PHI Authorization & Consent

Authorization MUST BE FIRST

Client signs to allow PHI storage & e-signatures

View Email
2

Part 1: Client Demographics

PHI STAFF ONLY

Staff collects via phone: name, DOB, SSN, address, insurance, contacts. Assigns Client Code.

View Call
3

HIPAA Notice of Privacy Practices

Acknowledgment

Client acknowledges receipt of privacy practices

View Email
4

Client Rights & Responsibilities

Acknowledgment

Client acknowledges their rights and responsibilities

View Email
5

Consumer Notice

Acknowledgment

DCW employment status, tax, workers comp, liability info

View Email
6

Complaint Process

Acknowledgment

How to report complaints & investigation process

View Email
7

Financial & Legal Restrictions

Acknowledgment

PA state regulations on POA, guardianship, check endorsement

View Email
8

Service Agreement

Authorization SIGN LAST

Terms of service, rates, payment, cancellation policy. Finalizes enrollment.

View Email

Phase 2: Data Collection

After legal forms signed. Forms 9 & 10 can be filled by client OR staff via phone.

Form Assessment Before Visit After Visit
9

Part 2: Client Profile

Form BEFORE VISIT No PHI

Preferences, communication, care needs, schedule, living environment. Uses Client Code only.

View Email Call
10

Person-Centered Survey

Form AFTER VISIT No PHI

Life story, preferences, daily routines, what brings joy, goals & wishes. Who they are as a person.

View Email Call
11

Functional Assessment

Assessment AT VISIT No PHI

ADL/IADL assessment using task codes 115-141. Staff assesses actual care needs in person.

View Staff Only
12

Environmental Assessment

Assessment AT VISIT No PHI

Home safety evaluation. Documents hazards, equipment, accessibility, and recommendations.

View Staff Only

Phase 3: Care Planning

Generate AI-powered care recommendations and finalize the Individualized Service Plan.

12
AI TOOL

AI Care Plan Generator

NO PHI INPUT

Staff tool that combines de-identified exports from Forms 8-10 to generate AI prompts for risk analysis and care plan recommendations.

How It Works:

Paste de-identified exports from Person-Centered Survey, Functional Assessment, and Environmental Assessment
Generator creates structured AI prompt with Client Code
Copy prompt to ChatGPT/Claude for risk analysis and care recommendations
Open Generator Used by: Office Staff
13
NO PHI

Care Plan / ISP

OUTPUT

The final Individualized Service Plan document. Built from AI recommendations and staff expertise, then reviewed and signed by client.

Contains:

Authorized Tasks Care Schedule Goals Special Instructions Risk Mitigations
View Template Created by: Staff → Signed by: Client
Care Begins!
Client is now fully onboarded

Process Flow

Visual overview of how forms connect and who completes each step.

Initial Contact
Lead Inquiry
PHI Authorization
Sign First
LEGAL & COMPLIANCE FORMS
HIPAA Notice
Client Rights
Consumer Notice
Complaint Process
Financial & Legal
Service Agreement (LAST)
Person-Centered Survey
Client/Rep
IN-PERSON HOME VISIT
Functional Assessment
ADL/IADL Eval
+
Environmental
Home Safety
Export de-identified data
AI Care Plan Generator
Risk Analysis & Recommendations
Care Plan / ISP
Client Signs
Care Begins
Welcome!
Form Type Completed By When
Phase 1: Legal & Compliance (Forms 1-8)
1. PHI Authorization JotForm Client/Representative First - before any data
2. Client Profile JotForm (PHI) Client/Representative Assigns Client Code
3. HIPAA Notice JotForm Client/Representative With compliance docs
4. Client Rights JotForm Client/Representative With compliance docs
5. Consumer Notice JotForm Client/Representative With compliance docs
6. Complaint Process JotForm Client/Representative With compliance docs
7. Financial & Legal Restrictions JotForm Client/Representative PA State Regulations
8. Service Agreement JotForm (FINAL) Client/Representative Last - finalizes enrollment
Phase 2: Data Collection (Forms 9-11)
9. Person-Centered Survey Webform Client/Representative Before home visit
10. Functional Assessment Webform Client/Representative Home visit
11. Environmental Assessment Webform Client/Representative Home visit
Phase 3: Care Planning (Forms 12-13)
12. AI Care Plan Generator Tool Office Staff After assessments
13. Care Plan / ISP Output Staff → Client signs Before care begins

Quick Links

Direct links to all forms and tools.

Phase 1: Legal & Compliance (Forms 1-8)

1. PHI Authorization
2. Client Profile
PHI
3. HIPAA Notice
4. Client Rights
5. Consumer Notice
6. Complaint Process
7. Financial & Legal
8. Service Agreement
FINAL

Phase 2: Data Collection (Forms 9-11)

9. Person-Centered Survey
10. Functional Assessment
11. Environmental Assessment

Phase 3: Care Planning (Forms 12-13)

12. AI Care Plan Generator
Staff Tool
13. Care Plan / ISP
Output

Other Resources

Client-Facing Intake
Send to Clients
All Forms Hub
Central Repository
Client Handbook
Reference
Documentation last updated: January 2026