If the individual you are submitting to the pool is involved with other service providers, please contact those service providers before submitting this form.

If the individual you are submitting to the pool is currently in a RRH program, you must contact their Case Manager in that program before submitting this form.

Prior to submitting this form, the individual MUST be enrolled in coordinated entry, have a MACCH Coordinated entry ROI (uploaded or electronic signature), and added to the community queue, all of which is done in HMIS.

To be added to the PSH pool during HRT, this form must be submitted by 4pm on the Tuesday prior to HRT.

Be prepared to attend HRT and present why you think this individual needs PSH and answer questions about this individuals circumstances.

We will contact you if we need any additional information to complete this submission.

If you have any questions, contact Cynthia Holaday choladay@endhomelessnesstoday.org or Lisa Vukov at lvukov@endhomelessnesstoday.org 

If you do not receive an email confirming your submission after submitting this form please email Cynthia Holaday at choladay@endhomelessnesstoday.org