T121 Intake to location handoff sheet
Intake to location handoff sheet
The sheet central intake completes for each file it hands to a location: the fields location staff reopen most, emergency contact first, the exceptions already accepted and who approved them, so the location acknowledges within one business day and does not ask again. Prepared by the central intake coordinator at Alderpoint Wellness Group for the front desk staff at the six locations. It covers the Fellbrook Community Credit Union wellness benefit. Issued Thursday, October 1, 2026.
Sample template: the firm, people, clients and figures are fictional.
The one open box on this sample sheet is the approver line for an accepted exception. It is entered on the sheet before the sheet goes out. The sheet shows case numbers and counts only, never the name of the person referred.
From handed off to acknowledged
Central intake handed 88 files to location staff in the week of Sep 21. Seventy-one were acknowledged within one business day and 17 were reopened with questions. The bars show the 88 coming down by the 17 reopened files to the 71 acknowledged.
Live example from the Dashboards app, shown with Fellbrook Community Credit Union's demo data. Block dates move forward each week, so they can differ from the sample dates on this page.
Live example from the Dashboards app, shown with Fellbrook Community Credit Union's demo data.
Why files were reopened
Three reasons account for all 17 reopened handoffs.
Larkin Street reopened 11 of the 17 handoffs
Eleven of the 17 reopened handoffs came from Larkin Street, mostly about missing emergency contacts. Larkin Street collects paper forms at the desk and scans them once a week, so a contact written on a paper form is not in the file when central intake builds the brief.
What changed. Yolanda Prentiss added accepted exceptions and their approver to the brief, and Rohan Bhattacharya confirmed each reopened handoff personally. Yolanda also required same-day scanning at all six locations. Ask. Central intake checks the emergency contact first on every Larkin Street file until the week of Oct 5 is measured.
Sample handoff table
Eight example rows from the week of Sep 21. They show how each file is logged. The totals above cover all 88 files.
| Case | Location | Handed off | Location response | Result |
|---|---|---|---|---|
| FB-1041 | Orchard Row | Mon, Sep 21 | Acknowledged Tue, Sep 22 | |
| FB-1044 | Millbank | Mon, Sep 21 | Acknowledged Mon, Sep 21 | |
| FB-1049 | Larkin Street | Tue, Sep 22 | Question raised Thu, Sep 24 | |
| FB-1052 | Northway | Tue, Sep 22 | Acknowledged Wed, Sep 23 | |
| FB-1058 | Larkin Street | Wed, Sep 23 | Question raised Fri, Sep 25 | |
| FB-1063 | Cedar Hollow | Thu, Sep 24 | Acknowledged Fri, Sep 25 | |
| FB-1067 | Riverside | Thu, Sep 24 | Acknowledged Fri, Sep 25 | |
| FB-1071 | Millbank | Fri, Sep 25 | Question raised Mon, Sep 28 |
Three of the eight rows were reopened, a larger share than the 17 of 88 across the week, so read the table as a layout and not as a rate.
What the numbers say
Live example from the Dashboards app, shown with Fellbrook Community Credit Union's demo data.
The brief behind each sheet
Each statement in a brief carries its source. Open the example below to see the form.
Sample brief lines for case FB-1075
| Statement | Source | Confirmed by |
|---|---|---|
| Emergency contact is in the file | Intake register, scanned Fri, Sep 25 | Central intake coordinator |
| Consent form is signed and scanned | Intake register, scanned Fri, Sep 25 | Central intake coordinator |
| Referral document was accepted as an exception | Rule: required forms complete one business day before the first appointment | Approved by Rohan Bhattacharya |
| First appointment is booked for Tue, Oct 6 | Scheduling record | Basil Moyano |
Acknowledged: case FB-1075
Location: Larkin Street
Owner of the next administrative step: front desk lead
Date and time acknowledged: filled in by the location
Questions for central intake: filled in by the location
The location should never have to ask for something we already accepted. If an exception is in the brief, so is the name of the person who approved it.
Next steps
How to use this template
Fill in one sheet for each file central intake hands to a location. Check the fields location staff reopen most, with emergency contact first, list every accepted exception with its approver, and name the source of each statement.
| Variable | Meaning | Required |
|---|---|---|
{{handoff.case_number}} | Case number of the file, never the name of the person referred | Required |
{{handoff.location}} | Location receiving the file | Required |
{{handoff.emergency_contact}} | Whether the emergency contact is in the file | Required |
{{handoff.required_items}} | Consent form, insurance card, referral document and emergency contact, each present or not | Required |
{{exception.approver}} | Person who approved each accepted exception | Required |
{{handoff.acknowledged_at}} | Date and time the location acknowledged the file | Optional |
{{handoff.reopen_reason}} | Reason a location reopened the handoff | Optional |
If a required value is missing, show Needs review in its place and hold the sheet; never guess a contact, an approver or a date. If the intake register cannot be read, show Unavailable instead of the counts.
The live Dashboards blocks on this page show the Fellbrook Community Credit Union demo profile. Point each block at your own client's profile, or remove it, before you share the page.