Follow the steps to effectively complete the form online.

1. Click ‘Get Form’ button to access the MD Recoverynet Housing Intake Form and open it in your preferred editing tool.
2. Begin by filling out the basic information section, which includes your ValueOptions M-Number, date of assessment, referring care coordinator, and referring agency. Ensure all fields are completed accurately.
3. In the gender section, indicate your gender identity and if applicable, state whether you are pregnant. Proceed to fill in your smoking status and veteran status, as these details are relevant to your housing assessment.
4. Move to the marital status section and select the appropriate option that reflects your current situation. Provide any additional information if necessary.
5. Complete the legal information/history section, detailing any pending cases or prior involvement with the criminal justice system. Be honest about the number of arrests in the past 30 days, if applicable.
6. In the mental/physical health section, answer the questions regarding co-occurring health issues. Provide your diagnosis and any plans for addressing these health issues, including current medications and mental health counseling arrangements.
7. Document any history of self-injurious behavior and provide explanations for all affirmative responses. Address any PTSD diagnoses and treatment plans clearly and thoroughly.
8. For the other state/provider agency involvement section, describe where you will receive outpatient substance use disorder treatment along with the date of your intake appointment. Mention any obstacles you may face in participating in the treatment.
9. In the family and support portion, indicate whether you have social support, describe your family relationships, and note if you have a recovery plan or sponsor.
10. Transition to the housing status section where you will specify your living situation prior to filling out the form. Provide a reason for leaving your last housing situation, and answer questions about past homelessness and risk for future homelessness.
11. Lastly, outline your housing goals and plans for paying for housing when RecoveryNet services conclude. Indicate any past experiences with supportive or recovery housing, including duration.
12. Once all sections are completed, review your form for accuracy. You can then save changes, download, print, or share your completed MD Recoverynet Housing Intake Form.

Begin filling out your MD Recoverynet Housing Intake Form online today to access the support you need.