Mending Communities, One Man, Woman and Child at a Time

Digital Forms Portal โ€” Select a form to get started

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Client Referral Form

Standard client referral form for internal and external referrals. Includes client demographics, agency information, referral type, housing assistance, and clinical services.

๐Ÿ“„ 1 page PDF โฑ ~3 min to complete License #2000054-08
Open Form โ†’
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Client Intake Assessment

Comprehensive Ryan White intake & biopsychosocial assessment. Covers demographics, HIV status, risk assessment, mental status exam, substance screening, and service planning.

๐Ÿ“„ 12 page assessment โฑ ~20 min to complete Project H.E.A.L.
Open Form โ†’
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Monthly Reporting Form

Monthly client progress report. Track program attendance, participation level, treatment progress, and generate counselor-signed PDF reports.

๐Ÿ“„ 1 page PDF โฑ ~5 min to complete ๐Ÿ“ˆ Progress tracking
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Security Deposit Portal

Security Deposit Assistance Policy & Landlord Security Deposit Agreement. Review guidelines, complete tenant acknowledgement, and sign landlord agreement.

๐Ÿ“„ 2 page PDF โฑ ~6 min to complete โœ๏ธ Tripartite signatures
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Client Consent & Rights Packet

Complete the client consent, handbook acknowledgement, privacy notice, rights acknowledgement, records releases, and emergency contact details online, then download the filled packet.

๐Ÿ“„ 15 page packet โœ๏ธ Typed or drawn signatures ๐Ÿ”’ Created in your browser
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Check Request Form

Prepare a staff check request with vendor details, amount, request reason, approvals, and internal processing fields.

๐Ÿข Staff use โœ๏ธ Typed or drawn approvals ๐Ÿ”’ PDF created in browser
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6-Month Self-Attestation

Complete the Ryan White statement online, add supporting documents, and download a completed PDF packet.

๐Ÿ“„ Fillable statement ๐Ÿ“Ž Local attachments ๐Ÿ”’ Files stay on your device
Open Form โ†’