New Coordinated Entry Assessing Agency Application

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This is an application to becoming a new agency to participate in Coordinated Entry in the Southern Nevada Homelessness Continuum of Care. Please note that the Coordinated Entry Services Working Group will review each application. Access to the Homeless Management Information System (or Comparable Database for domestic violence serving agencies), is required to participate.

Only one application required per agency. This is not an application for new individual assessors.

Email *

Agency/Organization *

Site(s) Address(es) of where agency will be assessing *

Hours of Operation for Coordinated Entry *

Telephone Number for Site(s) *

Will walk-ins be accepted or will appts be required for an assessment? *

Walk-ins accepted

Appointments only

Both are accepted

Name of Designated Contact from your Agency for the Application Process *

Position Title

Does your agency/organization have experience working with individuals/families/youth/veterans who are navigating homelessness? *

Adults without Children

Families

Youth

Veterans

None of the above

Other:

Required

Does your agency/organization have access to and utilizes the Homeless Management Information System (HMIS)? *

Yes

How many employees will need to attend Coordinated Entry Assessor Training? *

Please advise if you will be available to openly assess consumers who may directly contact your agency or be referred by an agency partner (open site), or if you only intend to assess current consumers of your agency (closed site). *

Assessor for own agency and community

Assessor for own agency only

I understand the expectations put forth with maintaining the fidelity of administering Coordinated Entry Assessment tools if my agency/organization is permitted to participate. *

I agree

I disagree

I have read and understand the definition of Coordinated Entry posted on https://helphopehome.org/coordinated-entry/ and agree to abide by this practice to help people in Southern Nevada experiencing homelessness to access services. *

I agree

I disagree

I have read and understand the definition of Fair Housing that is posted on https://www.clarkcountynv.gov/residents/assistance_programs/community_resources_management/fair_housing.php and agree to affirmatively further fair housing for all residents of our community. *

I agree

I disagree

Thank you for completing the application!

A member of the Coordinated Entry Services Working Group will be in touch regarding your application.

A copy of your responses will be emailed to the address you provided.

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