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Resource Detail

Resource Title: Adult HMIS Screening Form

Format: MS Word

Product Developer: Peer-to-Peer icon

Product Type: Training Materials

Date Completed: December 2008

Author/Organization: Hennepin County, MN


This assessment/intake screening form, used by Hennepin County, is to be completed for all adults and unaccompanied youth, 18 years of age or younger. The assessment includes the clients' housing situation at program entry, last permanent address, rental history, monthly income, disability information, drug and alcohol history, criminal background, personal barriers to getting/keeping housing, and income barriers to getting/keeping housing. This template might be a helpful tool for new users to HMIS.


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