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2. 
4. Instructions:
   Employment Services, emphasizes goal achievement and considers the circumstances and needs of the entire family. In a goal-achievement framework, families set individual goals that are meaningful to them. Completing the following survey will help us identify your families needs by taking a look at the whole picture so we can best serve you.
6. Case Number
   Your case number can be found on your EBT card. (Example-1B12345)
7. Date:
   Date:

   Date:
9. Employment

   1. Area of significant need
   2. Area of need
   3. Stable, but could improve
   4. Making Progress
   5. Thriving
11. Legal

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
13. Education and skills training

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
15. Housing

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
17. Transportation

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
19. Physical and mental health

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
21. Substance use

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
23. Safety

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
25. Child and family needs

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
27. Child Care

    1. Area of significant need
    2. Area of need
    3. Stable, but could improve
    4. Making Progress
    5. Thriving
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30. Email address

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