COP Client Recommendation Form COP Client Recommendation FormΔ Client NameClient PhoneAddressAddress Line 1Address Line 2CityStateZip CodeClient E-MailDoes the client own the home? Yes No UnsureReferring AgencyAgency Contact PersonAgency Contact PhoneAgency Contact E-MailSpecify the work that needs to be doneReasons why this work should be done/What is the client’s situation – could they play a part in work or are there any family nearby? Special client circumstances about which COP should be aware?While it is not required or even requested that the recommended person or family bear any of the cost of materials, some people want to do so in whole or in part. This does not have any bearing on whether COP decides to take on a project! Do you think this might be the case in this situation? Yes No UnsureAny additional information or questions?Submit Form
