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

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.

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 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

HMIS Manuals

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

Please let us know if you are unable to find the form you need, or if you have any questions or concerns.