Social Work and Counselling Case Intake Form

    Social Work and Counselling Case Intake Form

    Client's Particulars
    as per NRIC/FIN/Passport
    e.g.123A
    Please provide a short write-up of the issues faced (E.g. financial difficulty due to loss of job)
    Referred By

    Personal Data Protection Act (PDPA) clause: In compliance with the Personal Data Protection Act, Presbyterian Community Services is committed to protecting personal data we have collected from you. By providing your personal details in the process of this application, you are consenting for Presbyterian Community Services to use your personal data or disclose your personal data to third parties where necessary for the following purposes:

    1. assessing and evaluating your application for financial assistance,
    2. verifying your identity and accuracy of your personal details and other information provided,
    3. administration of the financial assistance,
    4. contacting you about and involving you in our activities,
    5. research and evaluation, and
    6. making a referral to another agency.