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Gathering registration information

Last edited: September 14, 2012

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The collection of background information about women and children is necessary to better understand their personal characteristics and experience of violence, as well as to identify the supports they are requesting or need.

Background information is best completed by shelter staff during the initial discussion that takes place when receiving a woman at the facility, and may be gathered using an intake form. The intake process should remain flexible in order to best support women to share critical information about their circumstances given the various potential challenges they may face (such as a heightened state of crisis/stress or language barriers) which may prevent them from completing the process.

Information may continue to emerge over the course of a woman’s stay at the shelter as she develops trust with shelter staff. Women have the right and may choose not to provide all information requested, which should not be pursued as it may cause further trauma for women to disclose (e.g. specific details about their exposure to violence) or may not be known to the woman (e.g. legal considerations, income).

Information should only be gathered if it is needed to provide assistance. The type of information gathered will vary depending on the services provided (e.g. if medical services are offerred, more detailed medical history will be needed than if women are referred to external healtrh care providers). Common information collected may include:

  • The reason for the request for services.
  • Any issues related to immediate crisis and related risks of future violence.
  • Social, emotional, educational, health, employment and family histories as relevant for services provided.

For example, information about children may be collected (including those accompanying their mother to shelters as well as children who may not be accessing the shelter, in order to better understand how to support the whole family. Details about children may include demographics and relevant background, history about custody and living arrangements, child welfare status, school information and health/behavioural issues).

Sample intake categories

Admission information

  • Admission date
  • Family composition (i.e. are there any dependents accompanying the woman or who are currently staying elsewhere, but may need to be reunited?)
  • Is the woman pregnant? If yes, due date? Medical contact, if any?
  • Referral sources – where did the woman hear about the shelter?

Demographic information

  • Date of birth
  • Current marital status
  • Ethnic background
  • Immigration status (including country of birth and date of arrival in country for immigrant or refugee women)
  • Number and ages of children, if relevant
  • Identification of social supports (names and phone numbers or addresses of key contacts)

Stability Factors

  • Employment status
  • Highest level of education completed
  • Source of Income at intake
  • Income at intake - Individual gross annual income
  • Issues requiring legal support (i.e. protection orders)
  • Living arrangements immediately prior to admission
  • Type of housing immediately prior to admission
  • Health and mental health status

History of exposure to violence

  • Type and frequency of exposure (may be collected as part of a risk assessment)
  • Status of current related health and injury issues
  • Level of trauma
  • Safety plan in place? Detail of plan

Source: Canadian Network of Women’s Shelters and Transition Houses.


During the process of gathering information (upon arrival, as well as during all other interviews, intervention or examinations, and counseling sessions), staff should:

  • Consider the most appropriate and sensitive approach to asking questions in order to reduce the risk that the woman will become distressed or offended. This should review the order, phrasing, and the tone used of questions asked.
  • Avoid asking repetitive questions to prevent a woman from providing the same information more than once.
  • Identify if information has already been provided on other forms or through earlier interactions, and complete or make notes on the relevant details using previously shared information.
  • Plan the sequence of questions, which should:
    • Begin with the least-sensitive questions to be best received.
    • Start with questions that show concern for the woman's well-being (e.g. comfort, health and safety needs), which can help to build confidence and trust in the service provider’s intentions.
    • Follow initial questions with neutral or unobtrusive questions (e.g. name, place of birth, former occupation, etc.).
    • Ask sensitive questions later in the process, which assists in developing a stronger relationship between the service provider and the woman and tends to result in gathering more reliable responses.
    • End with questions that recognize the person’s strengths and courage.
  • Consider the tone of the questions and communication, which can help to show compassion by conveying recognition of the pain of a woman’s experience and reluctance she may feel about discussing difficult memories or displaying strong emotions. Asking questions in a way that conveys concern and interest increases the likelihood that women will provide more accurate and thorough information.
  • Remind the woman or girl to take her time answering questions, and offer to return to sensitive questions at a later time.

Staff training is important to support their capacity to gather information in a respectful and survivor-centred manner. In particular, they need to understand how to: collect intake information in a conversational way; gather sensitive information (e.g. child welfare, addictions, mental health history); and balance the client’s needs with the information needed by the shelter.

Sample intake forms may be obtained from agencies and revised to meet the shelter’s requirements.