Phase 2

Sample Agency Assessment Forms

The Contract Form is used to document the issues, goals and tasks to be accomplished. Note that it includes tasks and timelines for both the social worker and the client. The Contract form promotes transparency and empowerment by promoting a collaborative process.

Download sample Contract Form

The Case Summary Form is used to summarize important family (or individual) assessment information including family history, financial information, social support, concerns, strengths and challenges. In addition, it summarizes goals, tasks and timeline information. After the intervention phase, a closing summary documents progress towards goals and the need for further services.

Download sample Case Summary Form

Open your notebooks and answer the following:

  1. Summarize the Stone Family History, as you would write it on the Case Summary Form.
  2. Assessment of the environmental context.
  3. In your summary, what information did you include? What did you leave out? Why?

Mapping A Social Problem

Review and take notes on the family and the influences from their community.

Go to Diagram

My Assess Tasks

Task 1

In the process of working with the community system, you find a family negatively impacted by the potential community changes. Develop an assessment of the family system using the family history and genogram. Also, examine the sample case summary and case contract forms to provide structure and agency records for your assessment.

Task 2

Use the sociogram to better understand the family and community systems. Note the interaction and mutual influence of these systems.

Task 3

Examine your own values. Note the value issues and conflicts resulting from your own background, community interactions, and values. How can you use the Code of Ethics as a guide in resolving these value conflicts?