DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Pantawid Pamilyang Pilipino Program
RISKS AND VULNERABILITIES If Yes, Check if this
None REMARKS
happened within
6 months /or 1 year ago
A. Economic
Has the family used credit or borrowed
money from non-relatives/friends to
meet specific needs such as food, medical
expenses, bereavement, etc.? (Specify the
intent for borrowing money.)
Has the family reduced budget allotment
for education and health to prioritize
other needs? (Specify the reason/s.)
Has the family sold acquired assets/goods
(such as jewelry, phone, furniture, bicycle,
motorcycle, house/lot, farm, etc.) to
augment for the basic needs? (Specify
what has been sold.)
Has the family pawned 4Ps cash card to
support daily or certain needs (i.e.,
emergency, health, etc.)? (Specify the
reason for pawning.)
Is there any family member who stopped
working? (Specify how many among
working-age members.)
Has the family experienced damage/s in
property/assets (e.g., vehicle, machinery,
a piece of land, etc.)? (Indicate reason/s
for damages.)
B. Health
Is there any family member who had a
miscarriage? (State who and if
applicable.)
FAMILY RISK AND VULNERABILITYASSESSMENT
Name of Respondent : _____________________________________________________________________
Household ID Number : _____________________________________________________________________
Position in the Family : _____________________________________________________________________
Address : _____________________________________________________________________
Contact Number : ______________________________________________________________________
Date of Interview : _______________________________________________________________________
Time Started : ______________________________________________________________________
Time Ended : _______________________________________________________________________
Has the family previously been referred to services as a result of previous assessments conducted such as GIS
and SWDI? If yes, briefly state the main reason for referral and the types of services and interventions provided,
if any. If there are too many services and interventions provided, attach the applicable progress notes.