Housing First Meeting Request Form

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Housing First Meetings are available to assist participants in creating a Housing Action Plan to gain and / or maintain stable housing.
Participants have input and decision-making power for all goals, actions, steps, and timelines.

Provider Requesting a Housing First Meeting *

Name of Participant *

Reason for Request *

Assist Participant to Gain Stable Housing

Assist Participant to Maintain Stable Housing

Goal of Participant *

Obtain Housing

Meet Lease Requirements

Acquire Skills and Tools to Maintain Housing

Address MH and SUD Service Needs that May Cause Barriers to Stable Housing

Other:

Required

Participant Strengths *

Positive references from previous landlords, employers, community members (e.g., church or local leaders)

Experience as a tenant

Work experience, education, or skills

Ability to develop rapport with landlords and neighbors

Willingness/motivation to work on plan

Income or employment

Support from family, faith-based, or other ommunity network

Completion of classes (e.g., tenancy, job training) & certificates

Experience with problem solving & navigating systems

Other:

Required

Housing Barriers *

No rental history

Evictions

Larger family (3+ children)

Single parent

Head of household 18-26

Sporadic or no employment history

Recent criminal history

Limited English proficiency

Debts/insufficient savings

Option 20

No high school diploma or GED

Insufficient or no income

No or poor credit history

Housing-related debts (back rent, utilities)

Chronic homelessness

Substance abuse/use

Domestic violence

Lack of valid ID

Lack of tenancy knowledge

Unresolved legal issues

Other:

Required

Steps Taken to Address Barriers - Please detail how staff has engaged participant and activities engaged in to assist participant in addressing barriers to stable housing. *

Housing First Meeting Goal of Provider *

Other People to Include in the Invite *

Availability - Days and Times Suggested *

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