Nonprofit / Free editable template

Beneficiary referral and intake decisions template

A clear intake process makes sure every referral gets a quick, fair decision and nobody is left waiting without a reply. This board runs a referral through four questions, about immediate risk, where the person lives, eligibility and capacity, with a named outcome at every exit and last quarter's share of referrals for each. Below sit referrals by source, what the intake assessment covers and a note on consent and data.

This is a planning example. Follow your own safeguarding policy and local procedures whenever someone may be at risk.

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Beneficiary referral and intake decisions example showing four decision questions with named outcomes, share of referrals at each exit, referral sources, assessment checklist and consent note
Everything in this example is editable. Replace the labels, move the shapes and adapt the layout to your work.

How to use this template

  1. Put risk first

    Ask about immediate risk of harm before anything else, and make the urgent route the same day, every day.

  2. Set clear eligibility

    Write eligibility questions people can answer yes or no, and give every no a warm handover to another service.

  3. Manage capacity openly

    If there is no space, put people on a waiting list with regular check-ins rather than closing the referral.

Questions about this template

Can I change the eligibility questions?

Yes. Edit the four question boxes, such as the borough or age range, then update the outcome boxes and the share of referrals each one receives.

Do I need an account to use it?

No. Open the template and edit it in your browser. Your work saves on this device. An account is optional if you want to sync your workspace.

Can I export the finished diagram?

Yes. Use Export in the editor to save a PNG, SVG or PDF, or download an editable .epicdraw backup.

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