Request to Add or Change an Agency to HMIS

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Please note for all new Agencies, you will need to agree to the following:
HMIS Privacy Security Plan
Sacramento Data Quality Plan

In addition, you will need to complete and submit to Sacramento Steps Forward the following:
Partner Agency Agreement
Inter Agency HMIS Data Sharing Agreement

Initial Security Audit Checklist

Completed forms need to be mailed to HMIS@SacStepsForward.org

All of these documents can be found at www.SacramentoStepsForward.org under Data/Requesting New Agencies Or Programs.

For all new Agencies, you will also need to complete the Add a (Sacramento or Yolo) CoC Project to HMIS form for each new project. All Agencies should have a minimum of 1 project.

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New Agency

Existing Agency

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CA-503 (Sacramento)

CA-521 (Yolo)

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Agency Name

Agency Address

Agency Phone Number

Agency Website

Agency Geocode

Name of Agency Executive Director / CEO

Agency Executive Director / CEO's Phone Number

Agency Executive Director / CEO's Email Address

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