Transfer-In

May Alvarado

Auth ReceivedTR-000103
GOALS Client ID
CL-008099
Current Agency
ABC NGO
Assigned GOALS Case Manager
Priya Nair
Date Created
1969-12-11
Transferring Programs
EmploymentHousing

Program Transfer Summary

ProgramCurrent AgencyRouteAuthorization StatusGOALS Program Status
EmploymentABC NGOTransfer to GOALSAuthorizedActive
HousingABC NGOTransfer to GOALSAuthorizedActive

Client Information

Preferred Name
Date of Birth
1987-12-02
ProviderOne ID
203118874WA
Primary Phone
(253) 555-0442
Secondary Phone
(253) 555-0443
Email
may.alvarado@email.com
Address
3391 S 12th Ave
Service County
Pierce
Service City
Tacoma
Preferred Contact
Text
Preferred Language
Spanish
Intake Source
Transfer-In

Current Agency and Provider

Agency
ABC NGO
Agency Contact
Terrence Poole
Agency Phone
(253) 555-9001
Agency Email
tpoole@abcngo.org
Current Provider
Angela Ruiz
Provider Phone
(253) 555-9004
Provider Email
Transfer Request Date
1969-12-11
Transfer Reason
Agency closing its Pierce County service line.
Additional Notes

GOALS Assignment

Case Manager
Priya Nair
Supervisor
Sam Vega
GOALS Service County
Pierce
GOALS Service City
Tacoma
Expected Transfer Date
1969-12-29
Internal Notes