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Worksheet 6

Community Resources: Service Providers

Ways to Use this Worksheet

  • Use it to document the formal resources in the community.
  • Use it to develop a resource directory which is specific to your community and to assist you in determining where there are gaps and barriers to service. 

Agency name: 


Days and Hours of Operation:


Sites of Service Provision: 






Mission and Purpose:


Description of Core Services Provided:


Eligibility Criteria:


Cost of services:


Summary of Client Population:


Funding sources:


Other information: