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Reporting Requirements and Assessments - Under Construction

Service Definitions and Reporting Requirements

Last updated 10/1/2024
SUDS Service Definitions and Reporting Requirements Spreadsheet

Assessment Forms - Word Versions Effective July 1, 2025

Below, download copies of the SUA Standard Assessment Forms in Microsoft Word Document format. Implementation of the new forms is required starting 7/1/2025. There are 4 versions of each assessment form:

  • Digitally Accessible English Version
  • Print Only English Version
  • Digitally Accessible Spanish Version
  • Print Only Spanish Version

Remember to provide the Client Information and FAQs sheet to every client. You can also find the  Optional Questions and additional resources for Assessment Forms below. All assessment forms were updated in May 2025.

New Assessment Form Breakouts, Effective July 1, 2025

Download PDF

Basic Assessment - Eff. 7/1/25

 Use the Basic Assessment for Counseling, Evidence-Based Disease Prevention and Health Promotion (EB), Reassurance, Screening, SNAP ED Fresh Conversations

Basic Assessment Print Only English (docx)Download
Basic Assessment Digitally Accessible English (docx)Download

Case Management Assessment - Eff. 7/1/25

Case Management Assessment Print Only English (docx)Download
Case Management Assessment Digitally Accessible English (docx)Download

Chore Assessment- Eff. 7/1/25

Chore Assessment Print Only English (docx)Download
Chore Assessment Digitally Accessible English (docx)Download

Congregate Assessment - Eff. 7/1/25

Congregate Meal Assessment Print Only English (docx)Download
Congregate Meal Assessment Digitally Accessible English (docx)Download

Home Delivered Meal Assessment - Eff. 7/1/25

Home Delivered Meal Assessment Print Only English (docx)Download
Home Delivered Meal Assessment Digitally Accessible English (docx)Download

Homemaker, Personal Care, Adult Day Assessment - Eff. 7/1

Homemaker, Personal Care, Adult Day Assessment Print Only English (docx)Download
Homemaker, Personal Care, Adult Day Assessment Digitally Accessible English (docx)Download

Material Aid Food Assessment - Eff. 7/1/25

Use the Material Aid Food Assessment for all Material Aid food sub-types:

Farmer's Market/CSA, Restaurant, Other Food, Groceries, Grab and Go Meal, Home Delivered Meals

Material Aid Food Assessment Print Only English (docx)Download
Material Aid Food Assessment Digitally Accessible English (docx)Download

Material Aid Health Assessment - Eff. 7/1/25

Use the Material Aid Health Assessment for all Material Aid non-food sub-types: 

Assistive Technology, Audiology, Dental/Oral Treatment, Dentures, Emergency Assistance, Glasses/Contacts, Health Equipment, Hearing Aid, Optometry, Special Equipment for Visually Impaired

Material Aid Health Assessment Print Only English (docx)Download
Material Aid Health Assessment Digitally Accessible English (docx)Download

Nutrition Counseling Assessment - Eff. 7/1/25

Nutrition Counseling Assessment Print Only English (docx)Download
Nutrition Counseling Assessment Digitally Accessible English (docx)Download

Transportation Assessment - Eff. 7/1/25

Transportation Assessment Print Only English (docx)Download
Transportation Assessment Digitally Accessible English (docx)Download

Family Caregiver Assessment - Eff. 7/1/25

Includes the information required for the caregiver and care recipient

Family Caregiver Assessment Print Only English (docx)Download
Family Caregiver Assessment Digitally Accessible English (docx)Download

Older Relative/Grandparent Caregiver Assessment - Eff. 7/1

Includes the information required for the caregiver and care recipient

Grandparent Caregiver Assessment Print Only English (docx)Download
Older Relative Grandparent Digitally Accessible English (docx)Download

Client Info & FAQs Sheet - Eff. 7/1/25

Required to be provided to all clients as part of the assessment and reassessment process.

Client Information & FAQs Print Only English (docx)Download
Client Information & FAQs English Digitally Accessible Version (docx)Download

Assessment Form Resources

Optional Questions for Assessment FormsAssessments FAQsNew Assessment Forms Comparison ChartAssessment How To GuideAssessments for Nutrition Programs Training from 5/15/25June 2nd Assessments Training - Coming Soon

Assessment Forms & Resources Effective through June 30, 2025

Below, download copies of the SUA Standard Assessment Forms in Microsoft Word Document format that you can use until June 30, 2025. Remember to provide the Client Information and FAQs sheet to every client. All the previous assessment forms were updated in April 2024.

ENGLISH Basic Intake Form April 2024 Version (docx)Download
SPANISH Basic Intake Form April 2024 Version (docx)Download
ENGLISH Congregate Nutrition Assessment Form (3) (docx)Download
SPANISH Congregate Nutrition Assessment Form (docx)Download
ENGLISH In Home Assessment Form April 2024 Ve (2) (docx)Download
SPANISH In Home Assessment Form April 2024 Ve (docx)Download
ENGLISH Caregiver Counseling Training Support (4) (docx)Download
SPANISH Caregiver Counseling Training Support (2) (docx)Download
ENGLISH Caregiver Respite Supplemental Servic (1) (docx)Download
SPANISH Caregiver Respite Supplemental Servic (docx)Download
ENGLISH Client Information and FAQs Sheet Apr (4) (docx)Download
PRINT VERSION_Client Information and FAQs She (1) (docx)Download
PRINT VERSION_ Optional Questions April 2024 (2) (docx)Download

Reports on Assessments and Reassessments in SUDS

Guide to the assessment and re-assessment report templates available in SUDS:

Link to All Users Report Templates Guide

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