MINDANAO INSTITUTE OF TECHNOLOGY INC.

DEPARTMENT OF SOCIAL WORK

Email add: alihasanie850@gmail.com

CASE STUDY REPORT

Date:

I. IDENTIFYING INFORMATION:
Name of Client :
Mobile Number :
Sex :
Birthday :
Age :
Place of Birth :
Civil Status :
Highest Educational Attainment :
Religion :
Occupation :
Occupational Skills :
Monthly Income :
IP Affiliation :
Disability (if Applicable) :
Source of Information :
HH level of well-being (present) :
Previous assessment (if applicable) :
Present Address :
Case Category :

II. FAMILY COMPOSITION:

Name S Age Civil / Monitored Occu- Highest Currently Occu Monthly Type of IP
e Marital Educational enrolled pa- Income Disabilit Affilia
x Status Child pation tional y tion
Attainment Skills
Yes No (This should Y No (if
be after
e applica
currently
ble)
enrolled) s

III. PRESENTING PROBLEM

Ano ang unang unang problema ng client na nagong sanhi ng kanyang pagka dysfunctional.
 MINDANAO INSTITUTE OF TECHNOLOGY INC.

IV. BACKGROUND INFORMATION

A. The Family

Name of all families, from MOTHER FATHER SIBLINGS (magkakasunod) pati edad at
educational attainment. Ilagay a relationship ng bawat myembero ng pamilya, kong meron
problema ano ito? Ilagay ang mga trabaho, at libangan ng pamilya.

B. Environment/ Community

Dito ilagay nyo ang relationship ng pamilya sa mga tao sa community.magand ba ang pakikitungo
ng pamilya sa ibat ibang tao lalo ng sa barangay? Aktibo ba ang pamilya sa mga aktibidadis sa
community. Active bas a simbahan at sa mga ibat ibang programa ng community ang pamilya?

V. CASE ASSESSMENT

Dito nakalagay lahat ng ngyari during interview sa client. First ano ang personal info ng client,
anong ang dati nyang Gawain, at ano ang problemang kanyang nasabi? Ano ang ibat ibang
klaseng problemang kinakaharap ng client. At sino ang support system nya? Sino ang kasama
nya at taga supporta nya? Ano ang nakikitang possibleng solution ng client sakanyang problema,
(state all of her/his strength) puwede rin mag apply ng mga theories para maintindihan lalo ang
problema ng client. Kailangan nakalagay dito kong WILLING ba ang client maki pag tulongan sa
client.

VI. INTERVENTION PLAN

Need/Problem Activities Responsible Person Timeline Expected Result

Dito ilagay ang

strength ng
client (in a form
of objective)
EXAMPLE: EXAMPLE: EXAMPLE: EXAMPLE: EXAMPLE:
“THE CLIENT REFER THE SOCIAL JANUARY- THE CLIENT IS ENROLLED
IS WILLING TO CLIENT TO WORKER JUNE 2023 AND WILL BE ACTIVE TO
ENROLLED PUBLIC SCHOOL CLIENT PARTICIPATE IN THE
TO SCHOOL” TEACHER SCHOOL ACTIVITIES

VII. RECOMMENDATION

Dito ilagay ang gusto nyo pang gawin ng client niyo na wala sa kakayahan niyo. Pero puwede e refer
sa ibat ibang ahensya ng gobyerno.

Prepared by: Ilagay dito ang pangalan at permhan

Date:

Approved by:

HASANIE M. ALI, RSW

Program Coordinator