Adult Intake Packet - ALPHA House of Pinellas County Inc: Fill out & sign online

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Click 'Get Form' to open the Adult Intake Packet in our editor.
Begin with the Admission Requirements section. Ensure you have all necessary documents ready, such as ID and birth certificates for both mother and child.
Proceed to the Emergency Data Sheet (Mother). Fill in your name, date of birth, social security number, and address. Be thorough when listing allergies and medical diagnoses.
Continue to the Emergency Data Sheet (Child) and provide similar information for your child. Make sure to include emergency contacts and any relevant medical history.
Complete the HIPAA Release Forms by specifying who can access your information. This is crucial for ensuring your privacy while allowing necessary communication.
Review all sections carefully before submitting. Use our platform's features to save your progress or make edits as needed.

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How does Alpha House help families?

Alpha House services aim to provide stability for parents and children living in the shelter, and guide them through a plan to secure and maintain stable housing. The program provides intensive support services that address each familys individual needs and barriers to securing permanent housing.

What is the alpha house in Pinellas County, Florida?

The mission of ALPHA House of Pinellas County is to prevent the cycle of homelessness and child abuse by providing a safe residence and supportive services to homeless pregnant women and babies.