• Tools and Templates

Homeless Prevention Pilot Assessment Form


Date Published: July 2005


Pickaway County, Ohio, uses this Excel spreadsheet as a client assessment/intake form for a homelessness prevention pilot program. The form collects information on the client's current living situation, nature of housing crisis, gross monthly income, and employment status. This may be useful to agencies looking to develop client assessment documents.

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Author Organization
  • Pickaway County, OH
Resource Approver
  • Peer Approved