Edit, Download, and Sign the Housing Navigation and Tenancy Referral Form

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How do I fill this out?

To fill out this form, gather all necessary member information and required documents. Carefully check the type of service requested, as well as the eligibility criteria. Complete the form accurately to ensure timely processing of your referral.

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How to fill out the Housing Navigation and Tenancy Referral Form?

  1. 1

    Gather the member's information and required documents.

  2. 2

    Select the type of service the member is requesting.

  3. 3

    Provide necessary contact information.

  4. 4

    Attach the member's updated individualized housing support plan.

  5. 5

    Submit the completed form online or via fax.

Who needs the Housing Navigation and Tenancy Referral Form?

  1. 1

    Individuals experiencing homelessness who need assistance finding housing.

  2. 2

    Formerly homeless individuals requiring support to maintain their housing.

  3. 3

    Social workers assisting clients in accessing housing services.

  4. 4

    Families at risk of homelessness needing resources for stability.

  5. 5

    Transitional-age youth seeking stable housing solutions.

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What are the instructions for submitting this form?

To submit the Housing Navigation and Tenancy Referral Form, you can do so online at www.CAHealthWellness.com or fax it to 866-724-5057. Make sure to include all required attachments, including the member's updated individualized housing support plan. Always double-check to ensure all sections are completed before submission to avoid any delays.

What are the important dates for this form in 2024 and 2025?

The crucial dates for submission of the Housing Navigation and Tenancy Referral Form include deadlines for housing assistance applications. Keep an eye on local housing agency schedules for potential updates in 2024 and 2025. Make sure to submit your forms promptly to meet the necessary timelines for assistance.

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What is the purpose of this form?

The Housing Navigation and Tenancy Referral Form serves a vital function in connecting individuals with essential housing services. It helps streamline the process of obtaining housing resources for those in need, including temporary and permanent solutions. By ensuring that eligible members are assisted promptly, the form improves access to housing stability.

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Tell me about this form and its components and fields line-by-line.

The form consists of various fields designed to collect necessary information from members seeking housing assistance. Each field is crucial for determining eligibility and service type.
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  • 1. Member Name: The full name of the member applying for housing services.
  • 2. Date of Birth: The date of birth of the member to establish identity.
  • 3. Medi-Cal ID: The Member's Medi-Cal identification number.
  • 4. Current Living Location: The current housing status of the member, indicating where they reside.
  • 5. Phone Number: Contact number for the member.
  • 6. Current Address: The current residential address of the member.
  • 7. Community Supports Provider Information: Details about the organization providing services to the member.
  • 8. Preferred Language: Language preference of the member for communication purposes.

What happens if I fail to submit this form?

If this form is not submitted, individuals may miss critical housing assistance opportunities. This could delay access to necessary services and resources that could improve their living situation.

  • Delay in Services: Failure to submit may result in delay in obtaining housing support services.
  • Increased Risk of Homelessness: Not submitting may increase the risk of remaining homeless or unstable in current housing.
  • Loss of Housing Resources: Potential loss of access to crucial housing resources and support networks.

How do I know when to use this form?

You should use this form when seeking housing transition and navigation services or tenancy sustaining support. It applies to individuals who are homeless or at risk of losing their housing. Completing this form is essential for securing the necessary assistance.
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  • 1. Seeking Housing Assistance: Use this form to apply for services that aid in finding stable housing.
  • 2. Maintaining Housing Stability: Utilize the form to access services that help sustain tenancy after obtaining housing.
  • 3. Eligibility Determination: Employ this form to determine if you qualify for various housing-related services.

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