Instructions: Identify three resources within your community that relate to the aging, disabled or chronically ill population. All sections must be completed, using complete sentences. Provide a reference page to show where you located the data. The boxes will expand as you type.
As this is information that you may use in your work setting, it is best to examine your local community. However, if services are minimal, you may wish to expand your search to the county or nearest city, depending upon your location.
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*** You may only use each facility/organization/entity under one heading. If they offer more than one type of service, that is fine, but you can only count it for one. You must include three unique organizations. ***
|Resource #1 (Physical need)||Resource #2 (Psychosocial need)||Resource #3 (transportation or entertainment need)|
|Name of the agency/resource|
|Contact information: Address, phone number, website|
|Is this a public or private agency?|
|What services are provided by this agency?|
|Who is eligible for services?|
|Are there any exclusions for services?|
|What are the costs for services? Is there a sliding scale payment plan?|
|What outside sources provide funding for this agency?|
|Name at least three important details that you learned about this agency.|
|Would you recommend this agency to a patient? Why or why not?|
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