Printable/Editable Intake Customer Intake Worksheet for CBO use. This worksheet was designed to be used by CBOs who do not have access to a computer during their appointments with customers. This form can be completed at the appointment and contains all the fields that are required to be updated in the Online EPIC System. After the appointment the CBO must update the online EPIC system to reflect what is on the worksheet.
This Resource is included with EPIC Pilot Program Resources