Get Mshmis Street & Shelter Intake Form (3.917a) - Mihomeless

The MSHMIS Street & Shelter Intake Form (3.917A) is a crucial document for individuals seeking assistance through street outreach, safe havens, and emergency shelters. This guide will provide clear, step-by-step instructions on how to complete the form online, ensuring a smooth and accurate submission process.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the intake form and open it in your preferred online document editor.
2. Begin by filling in the intake date and the name of the intake staff or case manager in the designated fields.
3. For the household information section, provide the full name of each person in the household. Indicate their relationship to the head of household using the provided options.
4. Collect and enter the social security numbers (SSN) for adults aged 18 and over, ensuring to select the appropriate SSN data quality option based on the information provided.
5. Record the date of birth for each household member, including the date of birth data quality options available for selection.
6. Complete the gender identity and race sections by selecting the most appropriate options for each individual.
7. If applicable, respond to the questions regarding disabilities, including type and duration, ensuring that the necessary documentation is referenced.
8. In the health insurance section, provide details about whether each household member has health insurance and specify the type if applicable.
9. Answer the homeless history interview questions accurately for all household members. This section may require additional sheets for complex histories.
10. Finally, ensure all required sections are completed, review the form for accuracy, and choose to save changes, download, print, or share the filled-out form as needed.

Start filling out the MSHMIS Street & Shelter Intake Form online today to access vital support and resources.