Get Hmis-erie: Hhs-rhy Exit Form

Completing the HMIS-Erie: HHS-RHY EXIT FORM online can streamline the process of documenting your exit from a program. This guide provides clear, step-by-step instructions to ensure you fill out the form accurately and efficiently.

Follow the steps to complete the form successfully.

1. Click 'Get Form' button to obtain the form and open it in a digital format.
2. Begin with the agency name and client name or identifier. Use block letters for clarity.
3. Fill in the project exit date by selecting the appropriate month, day, and year.
4. If applicable, indicate the client location. This section is only necessary if there are multiple Continuums of Care.
5. Move to the destination section. Choose the appropriate option from the given list that describes the client's exit destination. Be sure to bubble in the correct circle.
6. Complete the project completion status for the head of household, adults, and unaccompanied youth. Check the option that applies.
7. Proceed to the disabling condition section and mark 'yes' or 'no' based on the client's status.
8. Fill in specific information about disabilities, health conditions, and any relevant income. Be thorough to ensure accurate data collection.
9. Provide information regarding receiving non-cash benefits and health insurance coverage.
10. Complete the sections related to education and employment status, including the last grade completed and current work situation.
11. Address health statuses, including general, dental, and mental health, and include pregnancy status if applicable.
12. Answer questions regarding counseling received, exit safety assessments, and connections outside of the program.
13. Finally, fill in any optional contact information, and provide a signature confirming that all information is accurate and truthful.
14. After all fields are completed, save changes, and choose to download, print, or share the form as needed.

Complete the HMIS-Erie: HHS-RHY EXIT FORM online today to ensure your exit from the program is documented accurately.