Get Emergency Shelter Guest Intake Form - Clover

The EMERGENCY SHELTER GUEST INTAKE FORM - Clover is a critical tool designed to assist individuals seeking refuge and support in emergency situations. This guide provides clear, step-by-step instructions to help you complete the form accurately.

Follow the steps to fill out the intake form effectively.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering your name in the designated fields, ensuring to include your last, first, and middle names.
3. Provide your date and place of birth along with identification details as required on the form.
4. Fill in personal characteristics such as hair color, eye color, height, weight, and race/ethnicity.
5. Indicate whether you are a veteran by selecting yes or no.
6. List your spouse's name and current location, if applicable, followed by the names and ages of your children.
7. Answer the question regarding your homelessness experience and explain the circumstances if applicable.
8. Describe your plans for finding permanent housing, along with any previous involvement with social service agencies.
9. Indicate your employment status and provide details about your source of income if you are employed.
10. Disclose any disabilities you or your children may have, and mention if you are taking any prescription medications.
11. Answer questions regarding past use of alcohol or drugs and any addiction issues, providing explanations as necessary.
12. Address queries about any abusive relationships or referrals to the shelter.
13. Enter your emergency contact's name, address, and phone number for safety.
14. Declare if you are a registered sex offender or on probation/parole, including the name of your probation officer.
15. Review your entries for accuracy before affirming the correctness of your information with your signature and date.
16. Finalize your form by saving your changes, and choose to download, print, or share the form as needed.

Complete your documents online to ensure a smooth intake process.