It is important for workers to know some basic information about the person they are caring for that might impact their health and access to health care services. Here are some important things to know about the person.

• Date of Birth
• Identified gender
• Does the individual have a health card?
• What are the person’s current living arrangements?
  • Non-housing (Street, park, car) b. Emergency Shelter. c. Transitional Housing d. Psychiatric Facility e. Substance Abuse Treatment Facility f. Hospital g. Prison/Jail h. Shelter for abused persons i. Living with friends/family j. Rental Housing k. Own apartment or house l. Motel/hotel m. Other (specify)
• Where has the person lived in the past year?
  • Non-housing (Street, park, car) b. Emergency Shelter. c. Transitional Housing d. Psychiatric Facility e. Substance Abuse Treatment Facility f. Hospital g. Prison/Jail h. Shelter for abused persons i. Living with friends/family j. Rental Housing k. Own apartment or house l. Motel/hotel m. Other (specify)
• Are there any health concerns or any particular symptoms that are bothersome?
• What has made it difficult for the individual to get health care in the past?
• Who are the person’s friends and family?
  • How have they helped to get health care?
• Are there other agencies and care workers involved with the individual?
• Does the person have a doctor that regularly provides health care?
  • What has the experience been like working with these people?
  • What would make the experience better?
• Where does the individual go for health care most often? ( e.g. hospital Emergency Department, family practice clinic, shelter, drop in, outreach team)
  • What has the experience been like in getting health care at these places?
  • What would make this experience better?

This sheet lists key information to remember to collect and to use to record the responses: