Download DHS 7869

Program:
Branch:
Case number:
Worker ID:
Case name:
Date of notice:
JOBS Re-engagement Notice
Name
Address
City State ZIP
Did you know the Temporary Assistance for Needy Families (TANF) program provides
activities to help you meet your goals? These activities include:
 Goal setting and personal planning.
 Workshops for updating your resume and practicing interviewing skills.
 Helping you set goals to improve your basic living needs such as finding better
housing, medical assistance and stable child care.
We would like to help you move forward with your goals. Self-Sufficiency Program staff
have set up a time to review your plan and make changes to help you meet your goals. At
this meeting, you will have the opportunity to tell us about any of the following that may
be preventing you from reaching your goals.
 Medical or physical health concerns
 Mental health concerns
 Learning difficulties or disabilities
 Alcohol or drug concerns
 Safety issues
 Other issues
Your meeting is at the time and place below. If you can’t be there, call the number below
right away to set another time. If we don’t hear from you or you don’t go to our meeting,
your benefits may be reduced or stopped.
Appointment day/date:
Appointment place:
Additional information:
DHS contact:
Appointment time:
Phone number:
Oregon DHS will not discriminate against anyone. This means DHS will help all who qualify. DHS will
not deny help to anyone based on age, race, color, national origin, sex, sexual orientation, religion,
political beliefs or disability. You can file a complaint if you think DHS discriminated against you
because of any of these reasons.
“Equal opportunity is the law”
Auxiliary aids and services are available upon request to individuals with disabilities.
Print copies for: Client, DHS and Contractor
DHS 7869 (03/16), Recycle prior version