House Pre-Screening

A first step toward safe, supported housing.

This is a first application, not the whole form. It takes about ten minutes and you can complete it on a phone.

Almost every question is optional. Our staff will contact you to go through the rest together, including the parts that need paperwork you may not have to hand. We only need your name and a phone number to get started.

Some questions ask about risk, behavioral health and medication. You will be told exactly how that information is used before any of it is asked, and you can leave any of it blank.

Your answers are not saved until you press Submit on the last step, so please finish in one sitting.

    Your Information

    How to reach you, and the home you are interested in.

    Choose the home you would like to apply for. If nothing is listed yet, leave this and our staff will go through the available options with you.

    Your Officer

    Your probation or parole officer, if you have one. Skip this if it does not apply to you.

    Sharing Your Information

    What happens to what you tell us next.

    Completing this form electronically

    I agree to complete this application electronically and to receive related records electronically. I understand that I may ask for a paper copy of this application at any time, at no cost, by contacting contact@carpenterstouch.org, and that I may withdraw this agreement at any time by contacting the same address.

    Sharing information about your health and safety

    The next few pages ask about risks and triggers, behavioral health, and any medications you take. You do not have to answer any of them in order to apply, and leaving a question blank will not by itself decide anything.

    I authorize The Carpenter's Touch to collect this information and to share it with staff of The Carpenter's Touch who review housing applications, for the purpose of reviewing my application for housing and planning the support I would receive.

    I understand that this information will be used solely for that purpose, that I may decline to answer any question, and that I may ask for what I have given to be corrected or removed by contacting contact@carpenterstouch.org.

    Typing your name here is your signature, and is legally binding.

    Current Risk

    This helps us plan the right support. Answer what you are comfortable answering.

    Up to 300 characters.

    Up to 300 characters.

    Up to 300 characters.

    Up to 300 characters. Anything else you would like us to know.

    Behavioral Health Needs

    Only what you would like us to know now. Staff will talk the rest through with you.

    Leave blank if you would rather discuss this with staff instead.

    Current Medications

    Anything you take regularly. Leave blank if none.

    Current medications

    List anything you take regularly. Leave blank if none. Three spaces are shown; use "Add another medication" if you need more.

    Medication 1

    Medication 2

    Medication 3

    Goals & Strengths

    What you want to work toward, and what you already bring.

    Initial goals

    Please give us at least two goals you want to work toward.

    Goal 1

    Goal 2

    Your strengths

    Please give us at least two.

    Strength 1

    Strength 2

    Employment & Work

    Where you work now, if anywhere, and the work you are looking for.

    Are you currently employed?

    If you are working now. Skip this if you are not.

    For example, "8 months".

    Job skills and work desired

    Skills you already have, and the kind of work you would like. Worth filling in whether or not you are working now.

    Skill or work 1

    Skill or work 2

    Review & Submit

    Check your answers and agree to the program terms.

    Agreement & Acknowledgment

    By signing below, I acknowledge:

    • I have answered the questions in this application truthfully, to the best of my knowledge.
    • I understand this is a pre-screening application, not an offer of housing, and that submitting it does not guarantee a place.
    • I understand that Carpenter's Touch staff will follow up with me to complete the rest of this form, and that a decision is made after that conversation.
    • I agree to remain compliant with all Carpenter's Touch, supervision, and program requirements while I am part of the program.

    Typing your name here is your signature, and is legally binding.

    Once you submit, our staff will review your application and contact you. Submitting does not guarantee approval.