Coronavirus (COVID-19): Guidance for Homeless Service Providers Learn More ➝

CCHMIS e-Forms

Important Administration Updates

File (click to download) Description
Download Manual: CARES Collaborative HMIS (CCHMIS) Administration Manual (Policies & Procedures) (PDF)Review the policies and procedures for working with CARES HMIS.
Download DCN Poster: CCHMIS Data Collection Posted Sign (PDF)Inform clients about the collection of their data by posting a Data Collection Notice.
Download Form: CCHMIS Client Disclosure & Consent Form - 2019 Request clients to authorize or modify data sharing preferences. All clients must have this form on file.
Download FormCCHMIS Client Disclosure for Street Outreach and RHY Only Form - 2019Inform clients of HMIS data entry and request clients to authorize or modify data sharing preferences.
Download Form:COVID-19 (Coronavirus) Awareness Screening Form (PDF) (.docx)A new form is available to help with screening. The purpose of this screening is to ensure that participants in your program have awareness of COVID-19 (Coronavirus). This is not intended to be a medical screening or diagnostic tool. This screening tool is intended to help programs manage activities related to client awareness, potential personal contact, and general symptom monitoring.
Download Membership: CARES Collaborative HMIS Advisory Committee (PDF)View the members of the CARES Collaborative HMIS Advisory Committee.
Download Charter: CARES Collaborative HMIS Governance Charter (PDF)Learn about the governance responsibilities for the CARES Collaborative
HMIS and participating agencies.
Download Form:Informed Inclusion Form (PDF) (.docx)
A COVID-19 Client Informed Inclusion Form is available for use.

CCHMIS Forms and Manuals

Program TypeForm TypeFormNotes
AnyUpdateAdmission Record Update Form – UniversalUpdated April 2018
AnyUpdateFace Sheet Update Form – UniversalUpdated April 2018
AnyUpdateAging into Adulthood Update Form – UniversalUpdated April 2018
AnyIntakeHMIS Universal Data Elements Only Intake Form
AnyContactStreet Outreach Contact Form – UniversalUpdated April 2018
AnyAssessmentAnnual Assessment Form – UniversalUpdated April 2018
HHS: PATHIntakeServices Only – Intake Form – All ClientsUpdated April 2018
HHS: PATHIntakeStreet Outreach – Intake Form – All ClientsUpdated April 2018
HHS: PATHDischargeHHS: PATH All – Discharge Form – All ClientsUpdated April 2018
HHS: RHYIntakeBasic Center Program Emergency Shelter – Intake Form – All ClientsUpdated April 2018
HHS: RHYIntakeTransitional Living Program & Maternity Group Home – Intake Form – All ClientsUpdated April 2018
HHS: RHYIntakeStreet Outreach – Intake Form – All ClientsUpdated April 2018
HHS: RHYDischargeDischarge Form – BCP, MGH, TLPUpdated April 2018
HHS: RHYDischargeDischarge Form – Street OutreachUpdated April 2018
HUD: CoCIntakeCoordinated Entry – Intake FormAdded July 2019
HUD: CoCIntakePermanent Supportive Housing (PSH) – Intake formAdded July 2019
HUD: CoCIntakePermanent Housing – Intake Form – Adults & Head of Household – January 2019
HUD: CoCIntakePH Intake Form- Minor Household Members
HUD: CoCIntakeTransitional Housing – Intake Form – Adults & Head of Household – January 2019
HUD: CoCIntakeTH Intake Form – Minor Household Members
HUD: CoCIntakeRapid ReHousing – Intake Form – Adults & Head of Household – January 2019
HUD: CoCIntakeRRH Intake Form – Minor Household Members
HUD: CoCIntakeStreet Outreach – Intake Form – All Clients
HUD: CoCDischargeAll Projects (PSH/RRH/TH/SO) – Discharge formAdded July 2019
HUD: CoCDischargeHUD: CoC All – Discharge Form – All Clients
HUD: ESG / STEHPIntakeEmergency Shelter (ES) – Intake formAdded July 2019
HUD: ESG / STEHPIntakeEmergency Shelter – Intake Form – Adults & Head of Household – March 2019
HUD: ESG / STEHPIntakeES Intake Form- Minor Household Members
HUD: ESG / STEHPIntakeRapid ReHousing – Intake Form – Adults & Head of Household – January 2019
HUD: ESG / STEHPIntakeRRH Intake Form – Minor Household Members
HUD: ESG / STEHPIntakeHomelessness Prevention – Intake Form – Adults & Head of Household
HUD: ESG / STEHPIntakeHP Intake Form – Minor Household Members
HUD: ESG / STEHPDischargeES & Prevention – Discharge formAdded July 2019
HUD: ESG / STEHPDischargeStreet Outreach, Emergency Shelter, Rapid ReHousing – Discharge Form – All Clients
HUD: ESG and STEHPDischargeHomelessness Prevention – Discharge Form – All Clients
HUD: HOPWAIntakePermanent Housing – Intake Form – Primary Clients & Head of HouseholdUpdated April 2018
HUD: HOPWAIntakePH Intake Form- Minor Household MembersUpdated April 2018
HUD: HOPWAIntakeTransitional Housing – Intake Form – Primary Clients & Head of HouseholdUpdated April 2018
HUD: HOPWAIntakeTH Intake Form – Minor Household MembersUpdated April 2018
HUD: HOPWADischargeHUD: HOPWA All – Discharge Form – All ClientsUpdated April 2018
HUD: HUD/VASHIntakePermanent Housing – Intake Form – Adults & Head of HouseholdUpdated April 2018
HUD: HUD/VASHIntakePH Intake Form- Minor Household MembersUpdated April 2018
HUD: HUD/VASHDischargeHUD: HUD/VASH All – Discharge Form – All ClientsUpdated April 2018
VA: GPDIntakeGrant Per Diem – Intake Form – Adults & Head of HouseholdUpdated April 2018
VA: GPDIntakeGPD Intake Form – Minor Household MembersUpdated April 2018
VA: SSVFIntakeHomelessness Prevention – Intake Form – Adults & Head of HouseholdUpdated April 2018
VA: SSVFIntakeHP Intake Form – Minor Household MembersUpdated April 2018
VA: SSVFIntakeRapid ReHousing – Intake Form – Adults & Head of HouseholdUpdated April 2018
VA: SSVFIntakeRRH Intake Form- Minor Household MembersUpdated April 2018
Program TypeResource TypeForm
AnyManualHMIS Data Standards Manual for 2020
HUD: CoCManualCoC Program Manual
HHS: PATHManualPATH Program Manual
HHS: RHYManualRHY Program Manual
HUD: ESG / STEHPManualESG Program Manual
HUD: HOPWAManualHOPWA Program Manual
HUD: HUD/VASHManual2017 HUD/VASH Program Manual
VAManualVA Programs Manual
VAData GuideVA Provider Data Guide October 2019

Contact us if need assistance or if you have any questions or concerns.