Homelessness Intervention Case Closure Sheet
Client Details
Client Name
Case Number / ID
Date of Birth
Date Opened
Date Closed
Case Manager
Reason for Case Closure
Select Reason
Client secured permanent housing
Client disengaged
Transferred to another service
Other
If other, specify
Summary of Interventions Provided
Outcomes Achieved
Referrals Made
Follow-up Actions Required
Case Manager's Signature
Name
Date