CCHMIS Forms & Manuals

Important Administration Updates

Review the policies and procedures for working with CARES HMIS.

Inform clients about the collection of their data by posting a Data Collection Notice.

Request clients to authorize or modify data sharing preferences. All clients must have this form on file.

Inform clients of HMIS data entry and request clients to authorize or modify data sharing preferences.

Download Manual: CARES Collaborative HMIS (CCHMIS) Administration Manual (Policies & Procedures) (PDF)

Download DCN Poster: CCHMIS Data Collection Posted Sign (PDF)

Download Form: CCHMIS Client Disclosure & Consent Form – 2019

Download form: CCHMIS Client Disclosure for Street Outreach and RHY Only Form – 2019

COVID-19 (Coronavirus) Awareness Screening Form

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 as PDF File (.pdf) or Word Document (.docx)

HMIS Forms

Program Type	Form Type	Form	Notes
Any	Update	Admission Record Update Form – Universal	Updated April 2018
Any	Update	Face Sheet Update Form – Universal	Updated April 2018
Any	Update	Aging into Adulthood Update Form – Universal	Updated April 2018
Any	Intake	HMIS Universal Data Elements Only Intake Form
Any	Contact	Street Outreach Contact Form – Universal	Updated April 2018
Any	Assessment	Annual Assessment Form – Universal	Updated April 2018
HHS: PATH	Intake	Services Only – Intake Form – All Clients	Updated April 2018
HHS: PATH	Intake	Street Outreach – Intake Form – All Clients	Updated April 2018
HHS: PATH	Discharge	HHS: PATH All – Discharge Form – All Clients	Updated April 2018
HHS: RHY	Intake	Basic Center Program Emergency Shelter – Intake Form – All Clients	Updated April 2018
HHS: RHY	Intake	Transitional Living Program & Maternity Group Home – Intake Form – All Clients	Updated April 2018
HHS: RHY	Intake	Street Outreach – Intake Form – All Clients	Updated April 2018
HHS: RHY	Discharge	Discharge Form – BCP, MGH, TLP	Updated April 2018
HHS: RHY	Discharge	Discharge Form – Street Outreach	Updated April 2018
HUD: CoC	Intake	Coordinated Entry – Intake Form	Added July 2019
HUD: CoC	Intake	Permanent Supportive Housing (PSH) – Intake form	Added July 2019
HUD: CoC	Intake	Permanent Housing – Intake Form – Adults & Head of Household – January 2019
HUD: CoC	Intake	PH Intake Form- Minor Household Members
HUD: CoC	Intake	Transitional Housing – Intake Form – Adults & Head of Household – January 2019
HUD: CoC	Intake	TH Intake Form – Minor Household Members
HUD: CoC	Intake	Rapid ReHousing – Intake Form – Adults & Head of Household – January 2019
HUD: CoC	Intake	RRH Intake Form – Minor Household Members
HUD: CoC	Intake	Street Outreach – Intake Form – All Clients
HUD: CoC	Discharge	All Projects (PSH/RRH/TH/SO) – Discharge form	Added July 2019
HUD: CoC	Discharge	HUD: CoC All – Discharge Form – All Clients
HUD: ESG / STEHP	Intake	Emergency Shelter (ES) – Intake form	Added July 2019
HUD: ESG / STEHP	Intake	Emergency Shelter – Intake Form – Adults & Head of Household – March 2019
HUD: ESG / STEHP	Intake	ES Intake Form- Minor Household Members
HUD: ESG / STEHP	Intake	Rapid ReHousing – Intake Form – Adults & Head of Household – January 2019
HUD: ESG / STEHP	Intake	RRH Intake Form – Minor Household Members
HUD: ESG / STEHP	Intake	Homelessness Prevention – Intake Form – Adults & Head of Household
HUD: ESG / STEHP	Intake	HP Intake Form – Minor Household Members
HUD: ESG / STEHP	Discharge	ES & Prevention – Discharge form	Added July 2019
HUD: ESG / STEHP	Discharge	Street Outreach, Emergency Shelter, Rapid ReHousing – Discharge Form – All Clients
HUD: ESG and STEHP	Discharge	Homelessness Prevention – Discharge Form – All Clients
HUD: HOPWA	Intake	Permanent Housing – Intake Form – Primary Clients & Head of Household	Updated April 2018
HUD: HOPWA	Intake	PH Intake Form- Minor Household Members	Updated April 2018
HUD: HOPWA	Intake	Transitional Housing – Intake Form – Primary Clients & Head of Household	Updated April 2018
HUD: HOPWA	Intake	TH Intake Form – Minor Household Members	Updated April 2018
HUD: HOPWA	Discharge	HUD: HOPWA All – Discharge Form – All Clients	Updated April 2018
HUD: HUD/VASH	Intake	Permanent Housing – Intake Form – Adults & Head of Household	Updated April 2018
HUD: HUD/VASH	Intake	PH Intake Form- Minor Household Members	Updated April 2018
HUD: HUD/VASH	Discharge	HUD: HUD/VASH All – Discharge Form – All Clients	Updated April 2018
VA: GPD	Intake	Grant Per Diem – Intake Form – Adults & Head of Household	Updated April 2018
VA: GPD	Intake	GPD Intake Form – Minor Household Members	Updated April 2018
VA: SSVF	Intake	Homelessness Prevention – Intake Form – Adults & Head of Household	Updated April 2018
VA: SSVF	Intake	HP Intake Form – Minor Household Members	Updated April 2018
VA: SSVF	Intake	Rapid ReHousing – Intake Form – Adults & Head of Household	Updated April 2018
VA: SSVF	Intake	RRH Intake Form- Minor Household Members	Updated April 2018

HMIS Manuals

Program Type	Resource Type	Form
Any	Manual	HMIS Data Standards Manual for 2020
HUD: CoC	Manual	CoC Program Manual
HHS: PATH	Manual	PATH Program Manual
HHS: RHY	Manual	RHY Program Manual
HUD: ESG / STEHP	Manual	ESG Program Manual
HUD: HOPWA	Manual	HOPWA Program Manual
HUD: HUD/VASH	Manual	2017 HUD/VASH Program Manual
VA	Manual	VA Programs Manual
VA	Data Guide	VA Provider Data Guide October 2019