Get Ca Homeless Management Information System User Account Request Form 2018-2025

Filling out the CA Homeless Management Information System User Account Request Form online is an essential process for users seeking access to the HMIS. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the user account request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter today’s date in the field provided. This helps to track when the request was made.
3. Provide the user’s first and last name in the designated fields to identify the new user.
4. Fill in the user organization name to establish the affiliation with the program.
5. Enter the user's office phone number, including the extension if applicable, in the format requested.
6. Indicate the user’s role or job title to clarify their function within the organization.
7. Complete the user’s email address to enable communication related to the account.
8. Submit the background check statement, confirming the user has passed a criminal background check, by having the authorized signature from the Executive Director or Agency Manager.
9. Sign and print the name of the authorized individual to validate the background check statement.
10. Read and agree to the authorization and confidentiality statement, sign, and print the name of the authorized individual.
11. Fill in the organization and program information, including the main office address and the relevant program the user will need access to.
12. Ensure the user has completed the necessary training and confirm their authorization as a CES-HMIS user.
13. Review the user’s responsibility statement and initial each item to indicate understanding of the proper use of the username and password.
14. Sign and date the user’s responsibility statement to acknowledge compliance.
15. After completing all sections, save the changes made to the form. You can then download, print, or share the completed form as needed.

Complete the CA Homeless Management Information System User Account Request Form online today to ensure timely access.