Homeless intake form 2026

1. Click ‘Get Form’ to open the homeless intake form in the editor.
2. Begin by entering your name, date, and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in your Social Security number and contact details, including your current residence and alternate means of contact. This helps case managers reach you easily.
4. Indicate your current living situation by checking the appropriate box that meets HUD's definition of homelessness. If applicable, attach the Certificate of Homelessness.
5. Answer whether you can be considered chronically homeless and provide documentation if available. Specify any qualifying disabilities and ensure relevant documentation is attached.
6. List all household members along with their relationships, dates of birth, ages, and Social Security numbers to complete demographic information.
7. Detail your total household monthly income from various sources. This section is vital for assessing eligibility for assistance programs.
8. Complete the asset declaration section by certifying that all listed assets are accurate and that you have not disposed of significant property recently.
9. Finally, sign and date the application at the bottom before submitting it along with required documentation such as proof of income and disability verification.

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