HIPPY Intake Procedures

If the Intake originates in the HIPPY department

1. HIPPY staff is responsible for making the initial entry on the

main event sheet and create a consumer file.

2. If a referral is made to another department, you are not

responsible for making any entry on that department event
sheet. However you do have to make an entry on the main
event sheet stating that a referral to the department has been
made.

3. After an Intake has been completed, it should be given to the

HIPPY coordinator for review within one business day.

Explanations for event sheet entries

1. When a consumer receives an services, it must be documented

on the main event sheet and the department event sheet (this
is done monthly with total number of hours)

2. Any time something is added to the consumer file, it must be

recorded on the main event sheet.

3. When a consumers case is closed the reason it is closed is to

be documented on the main event sheet and the department
event sheet in the main file. It is also documented on the
department file event sheet.

4. The entries must be clearly and neatly written with all errors
marked through with one line and initialed.

HIPPY Intake Consumer Forms

Updated 3/15/2017
 *All forms can be accessed through Box

1. HIPPY Parent Application Packet

HIPPY Application
Center Permission Form
HIPPY Permission Form
(Additional Child Applications for Multiple Children)
2. File Guide
Event Sheet
1- Parent Application
2- Child Application
3- Follow Up information
4- HIPPY Plus Testing Forms
5- Home Visitation Records
6- Correspondence
7- Case Details
8- Case Staffing
9- Q&A

3. Follow-Up Forms- each of these are to be filled out by the

home visitor (with all needed signatures) BEFORE given to
the Coordinator before filing in consumer file.
Consumer Status Update
Family Retention Strategy Form
HIPPY Family Concern Form
Family/Individual Exit Form

Updated 3/15/2017