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International Needs Assessment

A sample form for assessing the needs of families relocating to the United States.

July 25, 2001
Related Topics: Expatriate Management, Relocation Management

ear Transferee:

Thank you so much for taking the time to fill out this Needs Assessment form. The information you share with us will help us to better assist you. Your relocation counselor will phone you for further discussion after reading your responses.

CompanyName: ______________________
OfficePhone: ______________________
MobilePhone: ______________________
HomePhone: ______________________
NewCompany Address:______________________
  1. Please list any pertinent travel information:

  2. Do you have a passport: ______

  3. Do all accompanying family members have passports: ______

  4. If yes, please provide expiration dates:

  5. Do you have a driving license from any of the following (please circleall that apply):

    • United States
    • International
    • Home Country

  6. Are you planning to rent, lease, or buy a vehicle during your stay:______

  7. Are you bringing any family pets with you: ______

  8. What is your anticipated move date: ______

Dates: _____________
FlightNumber:  _____________
DepartureCity:  _____________
DepartureTime:  _____________
ArrivalCity:  _____________
ArrivalTime:  _____________
ArrivalAirport:  _____________

Where will you bestaying during your trip (name/address of hotel):



  1. What type of permanenthousing are you interested in finding (circle all that apply):

    • House
    • Apartment
    • Duplex/Townhouse

  2. How many bedrooms/bathroomswill you need: bedrooms ___ bathrooms ___

  3. Will you be bringingfurniture, or will you be renting: ______

  4. Do you preferto live in a city, or suburban environment: ______

  5. How far are youwilling to commute: ______

  6. How far are youwilling to travel for shopping, sporting/cultural events, etc: ______


  1. Would you like us to research any activities for you?

  2. Are any of your family members having difficulty adjusting to relocation?If so, bringing this to our attention will make it possible for usto make suggestions that might help: ______

  3. Do you or any of your family members have special medical circumstances:

  4. If so, are there facilities and/or services you would like us toresearch for you: ______


  1. Will you be seeking employment: ______

  2. If so, what is your occupation: ______

  3. Do you have a work visa, or will you need to be sponsored: ______

  4. Are you interested in volunteer or continuing studies programs: ______

  5. Would you be interested in joining expatriate groups or other typesof organizations: ______

  6. Would you like us to research any sports or activities:


Age/Dateof Birth:
Levelof Education:

  1. Do your children speak English:______

  2. Please describe any language needs your children might have:

  3. What type of schooling situations can we research for you:

  4. Please describe any special educational needs your children mighthave:

  5. Will you need information regarding day care and/or in-home childcareoptions: ______

  6. What sports or activities can we research for your children? Pleaseinclude skill level where necessary:

Please discuss anyadditional matters you would like to make us aware of:




Soruce:Cornerstone Relocation Group

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