Rate a beneficiary's needs across life domains, spot which are urgent versus unmet, and get an AI service-planning report — a warning sign, not a diagnosis.
Quick answer
Use it at intake or case review to rank a beneficiary's needs across housing, health access, income, relationships and safety — the scored output separates what is urgent from what is chronically unmet and feeds the service plan. It signals needs; it is not a clinical diagnosis.
Case notes describe needs; this assessment locates and ranks them. The respondent or support worker rates domains — housing stability, health access, income, relationships, safety — on urgency and coverage at once, so the report separates what is acute from what is chronically unmet. It borrows the classic needs frame (felt, expressed, normative and comparative need) to keep planning honest. The output guides service design; it is a warning light, never a diagnosis.
Sample form and report preview — live and ready to fill in.
Everything you need to run this template.
Ratings assemble into a picture across life areas, not one score.
Two questions per domain separate fire from leak.
A dedicated safety item routes to immediate help text, not the report queue.
One printable page naming priorities for the planning conversation.
From copy to deliverable in four steps.
Copy it in and adapt domains to your service scope.
Done with a support worker or self-paced — same instrument.
The AI summary ranks urgent vs chronic unmet needs.
Put top-ranked domains into the service plan and re-check quarterly.
Pick your role — see how it fits your workflow.
Open the plan conversation with a ranked picture.
See urgency and chronicity pulled apart before deciding.
Handoffs carry the same shared frame.
What makes this template work as a professional deliverable.
A preview of the real questions in this form — exactly what respondents see.
