Housing Registry External Referral Form 2026

1. Click ‘Get Form’ to open the Housing Registry External Referral Form in the editor.
2. Begin by filling in the REFERRAL DATE and REFERRAL SOURCE fields. Ensure you provide accurate contact information for the referral source.
3. Enter the FULL NAME, DATE OF BIRTH, and CURRENT ADDRESS of the individual requiring assistance. This information is crucial for identification purposes.
4. Provide PHONE # and ALTERNATE CONTACT # to ensure effective communication.
5. Detail any MENTAL HEALTH DIAGNOSIS and OTHER COMMUNITY AGENCY INVOLVEMENT to give context to the request for support.
6. Clearly state the REASON FOR REQUESTING SUPPORT, ensuring it reflects the individual's needs accurately.
7. Indicate PREFERRED TYPE OF ACCOMMODATION and LOCATION(S) that best suit the individual’s situation.
8. Complete sections regarding INCOME SOURCE, TOTAL MONTHLY INCOME, and MONTHLY RENTAL BUDGET to assess financial eligibility.
9. Fill out any relevant details about ACCESS TO LAST MONTH’S RENT, ELIGIBILITY FOR HOUSING RETENTION FUND, and special considerations like mobility issues or medical conditions.
10. Finally, review all entries for accuracy before submitting your completed form through our platform.

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