Templates & Samples

Below are templates and samples of policies/protocols/procedures for download.  Feel free to review and use any of the documents.


 Survey Template 


Spanish Survey Template 


Other Templates

Release of Information

Client Notice of Rights/Confidentiality

Client Intake Form 


TANF Affidavit

English Affidavit

Spanish Affidavit 


Sample Policies/Protocols/Procedures

Sheltering Teen Boys

Confidentiality Policy

Nonproselytization Policy

Releasing Information to Client

Serving Clients with Mental Health/Substance Abuse Issues 

Grievance Procedure

Disaster Plan


If there is a template or sample policy/protocol/procedure that would be helpful to have on the website, please contact Chelsea Baldwin.