CoC & HMIS Forms

Below are those forms that programs need for intakes, exits, and various types of assessments (such as the Verification of Homeless form; and the Income Verification form). Please contact HMIS Project Staffif you have questions about anything that is posted below, or if you would like additional information!

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HMIS Intake & Exit Forms

These have been updated to reflect 2014 HUD Data Standards.


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HUD Universal Intake for individual emergency shelters

HUD Intake and Exit form for all program settings

Verification of Homelessness Form for all programs except prevention programs

Verification of Homeless Risk for prevention programs


Coordinated Entry Forms


Looking for a printable version of the pilot Coordinated Assessment form? Get it here.


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CoC Grantees must use the Universal Application for entries into their program. The application consists of an intake and
the additional eligibility forms (listed below) that HUD requires for HUD-funded TH and PH programs.

The Universal Application is an important part of what will become the Coordinated Intake process, which will streamline
the process of matching appropriate housing resources to those persons who need them.
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Eligibility: Universal Application & Checklist


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Download all forms or just the sections you need.


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Universal Application - All Forms - intake has not been updated yet to conform with updated and new HUD requirements.

Verification of Homeless Form

Chronic Homeless Verification - updated to reflect the new recordkeeping requirements published in the Defining Chronic Homelessness Final Rule published December 4th, 2015.

Income Verification

Disabling Conditions Verification


Other CoC Forms

Don't see what you need? Contact the CoC Lead. .

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Site Visit checklist

● Project Ranking Template for 2017




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