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  • Wa Phoenix Transitional Housing Program Referral Form 2018

Get Wa Phoenix Transitional Housing Program Referral Form 2018-2026

Phoenix Transitional Housing Program 703 E. Hart son Spokane, WA 99202 Telephone: (509) 2327081 Fax: (509) 2327085Referral Form Today's Date: Person Making Referral: Client Name:Phone: First: Middle:.

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How to fill out the WA Phoenix Transitional Housing Program Referral Form online

This guide provides a comprehensive overview to assist users in completing the WA Phoenix Transitional Housing Program Referral Form online. By following these detailed steps, you will be able to accurately fill out the necessary information to facilitate the referral process.

Follow the steps to effectively complete the referral form.

  1. Click ‘Get Form’ button to obtain the referral form and open it in your chosen editor.
  2. Begin by entering today’s date in the designated field. This helps establish when the referral is being made.
  3. Enter the client’s information, starting with their name by filling in the first name, middle initial, and last name.
  4. Record the client's date of birth in the appropriate field to verify age.
  5. Indicate the client's gender by selecting either M or F, as applicable.
  6. Input the client’s phone number and a message phone number, offering alternate contact methods.
  7. Answer the question regarding any past criminal convictions by selecting 'Yes' or 'No'. If 'Yes,' provide details on the conviction, date, and state.
  8. Review the terms regarding the Fair Credit Reporting Act, and ensure the client understands their rights regarding personal information.
  9. Complete the sections about current housing by detailing whether the client is currently inpatient or housed, including relevant locations and discharge dates.
  10. Indicate if the client is currently enrolled in services, such as Behavioral Health or legal supervision, and outline court involvement if applicable.
  11. Outline any reasonable accommodation requests alongside details for minor children if applicable.

Take action now and complete the WA Phoenix Transitional Housing Program Referral Form online to ensure timely assistance.

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