Crisis counselors are required to document the services they provide. Collecting data on disaster survivors and the services they receive supports ongoing evaluation of your CCP.
Basic Data Collection Forms and Training
There are three basic forms submitted to CCP team leaders after each encounter.
- Individual/Family Encounter Log (OMB 2025) (PDF | 187 KB)
- Group Encounter Log (OMB 2025) (PDF | 219 KB)
- Weekly Tally Sheet (OMB 2025) (PDF | 276 KB)
Prior to using the data collection forms, staff should complete the CCP Data Collection Training. The training takes about 50 minutes. The training contains four modules:
- Module 1 provides an overview of the Individual/Family Encounter Log and the Adult and Child/Youth Assessment and Referral Tool forms. This module is about 20 minutes.
- Module 2 explains how to complete the Group Encounter Log to capture data on group counseling and public education sessions. This module is about 10 minutes.
- Module 3 explains how to complete the Weekly Tally Sheet to capture brief encounters, material distribution, and media efforts. This module is about 10 minutes.
- Module 4 provides an overview of the CCP data collection systems and reviews the data entry process. This module is about 10 minutes.
You may also want to review answers to common questions about CCP data forms in CCP Data Forms: Frequently Asked Questions (PDF | 209 KB).
The basic CCP data collection forms are also available in Spanish.
- Registro de visita individual o familiar para servicios de consejería en tiempos de crisis (OMB 2025) (PDF | 268 KB)
- Registro de la visita de grupo (OMB 2025) (PDF | 255 KB)
- Hoja de cómputo semanal (OMB 2025) (PDF | 287 KB)
Assessment and Referral Tools and Training
Service providers also use advanced tools known as Assessment and Referral Tools. Prior to use of these tools, staff should review the Adult Assessment and Referral Tool Guidance (PDF | 120 KB) document.
- Adult Assessment and Referral Tool (OMB 2025) (PDF | 219 KB)
- Adult Assessment and Referral Tool Response Card (PDF | 159 KB)
- Child/Youth Assessment and Referral Tool (OMB 2025) (PDF | 244 KB)
- Child/Youth Assessment and Referral Tool Response Card (PDF | 74 KB)
These forms are also available in Spanish.
- Herramienta para la evaluación y remisión de adultos (OMB 2025) (PDF | 261 KB)
- Tarjeta de respuestas (para entregar a las personas antes de la evaluación) (PDF| 64 KB)
- Herramienta para la evaluación y remisión de niños y jóvenes (OMB 2025) (PDF | 265 KB)
- Tarjeta de respuestas (PDF | 62 KB)
Feedback Surveys and Forms
Feedback from disaster survivors and service providers helps grantees improve CCP services in real time and keep program goals on track.
Participant Feedback
Use the Participant Feedback Survey (OMB 2025) (PDF | 320 KB) to collect feedback from disaster survivors who have received CCP services. This survey is also available in Spanish (OMB 2025) (PDF | 265 KB).
Use the following resources to help you collect feedback from CCP participants:
- Participant Feedback Survey: Guidelines for Trainers (PDF | 115 KB)
- Participant Feedback Survey: Guidelines for Counselors (PDF | 97 KB)
- Participant Feedback Survey: Cover Letter (DOC | KB)
Service Provider Feedback
Use the Service Provider Feedback Form (OMB 2025) (PDF | 380 KB) to collect feedback from CCP crisis counselors. This survey is also available in Spanish (OMB 2025) (PDF | 231 KB).
Use the following resources to help you collect feedback from CCP service providers:
- Service Provider Feedback Form Task Timeline (PDF | 237 KB)
- Boilerplate Service Provider Feedback Form Announcement (DOCX | 23 KB)
- Boilerplate Service Provider Feedback Form Announcement: Paper Version (DOCX | 24KB)
- Boilerplate Service Provider Feedback Form Cover Letter (DOCX | 31 KB)
- Boilerplate Service Provider Feedback Form Cover Letter: Paper Version (DOCX | 21 KB)
- Boilerplate Service Provider Feedback Form Thank You/Reminder (DOCX | 24 KB)