Refugee Resettlement Program Assessment
1. Client Information
Full Name
Date of Birth
Date of Arrival
Country of Origin
Family Members Accompanying
2. Housing & Basic Needs
Current Housing Status
Permanent
Temporary
Shelter
None
Comments
Unmet Basic Needs
3. Health & Wellbeing
Medical Issues
Mental Health Concerns
4. Education & Employment
Highest Level of Education
Employment Status
Employed
Unemployed
Student
Skills/Professional Background
5. Language & Integration
Native Language
English Proficiency
Fluent
Intermediate
Basic
None
Integration Support Needed
6. Additional Notes