Contributory HMIS OrganizationContact Information Fill 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Organization Name at the top of the form. This identifies your agency.
3. Fill in the Chief Executive's name and organization phone number to ensure proper contact information is recorded.
4. Next, provide details about the Project Name and Project Type (e.g., Emergency Shelter) to clarify the nature of your project.
5. Complete the Project Manager section with their name, email, and phone number for direct communication regarding project management.
6. Indicate whether HMIS is required for your project by selecting 'YES' or 'NO'. If yes, specify which agency requires its use.
7. Designate an HMIS Security Officer and provide their contact number. This person will oversee data confidentiality and compliance with policies.
8. List HMIS Reporting Contacts responsible for various reporting needs such as LSA, HIC, PIT, APR, ESG, and SPM.
9. Identify your IT Point of Contact for technical support related to HMIS.
10. Initial next to each policy acknowledgment to confirm receipt of important documents before signing at the bottom of the form.

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