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HIS HOUSEHOLD QUESTIONNAIRE (INTAKE) Check only one per question except where noted Answers in bold have additional followup questions DK client doesn't know Adapted from form developed by Lutheran

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How to fill out hmis household questionnaire intake

01

Start by gathering all the necessary information about the household members. This includes their names, ages, gender, and relationship to the head of the household.

02

Begin filling out the demographic information section of the questionnaire. This includes details about the race, ethnicity, and primary language spoken by each household member.

03

Move on to the housing information section and provide details about the type of housing, tenure, and duration of stay at the current residence.

04

Fill out the income and benefits information section. This includes details about the household's income sources, amount earned, and any public assistance or benefits received.

05

Answer the questions about homelessness, including details about any previous homeless episodes, reasons for homelessness, and current housing status.

06

Provide details about any disabilities or health conditions of the household members.

07

Complete the education and employment information section, including details about the highest level of education completed and employment status.

08

Finally, review the completed questionnaire for accuracy and make any necessary corrections before submitting it.

Who needs hmis household questionnaire intake?

01

HMIS (Homeless Management Information System) agencies and organizations working with homeless individuals and families need the HMIS household questionnaire intake.

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What is hmis household questionnaire intake?

HMIS Household Questionnaire Intake is a form used to collect information about individuals and families experiencing homelessness, in order to track and provide services to those in need.

Who is required to file hmis household questionnaire intake?

Service providers who work with homeless individuals and families are required to file HMIS Household Questionnaire Intake.

How to fill out hmis household questionnaire intake?

HMIS Household Questionnaire Intake can be filled out by collecting information from homeless individuals and families, and entering it into the designated software or database.

What is the purpose of hmis household questionnaire intake?

The purpose of HMIS Household Questionnaire Intake is to gather data on homelessness in order to better understand the issue, track individuals and families in need, and provide appropriate services.

What information must be reported on hmis household questionnaire intake?

Information such as demographic details, housing status, income, health conditions, and service needs must be reported on HMIS Household Questionnaire Intake.

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