Start Your Application for Structured Transitional Housing

Read the information and complete the application below to begin the intake and assessment process.

All submissions are reviewed to ensure program fit and readiness.

1. Gather Your Information

Before starting, have the following ready:

Personal info (Name, DOB, Gender, Contact)

Emergency contact details

Current housing & legal status

Employment & program readiness info

Strengths, goals, and any health/substance use info

2. Fill Out the Online Form

Start by filling out the fields with your information

Complete all required fields (*marked with an asterisk)

Select options for multiple-choice questions

Provide details where requested (e.g., “Other” or “Specify”)

Read and acknowledge all agreements

3. Review Your Application

Double-check all information for accuracy

Ensure signatures and initials are provided

4. Submit

Click Submit to send your application

You will see a confirmation message once submitted

5. After Submission

Our Intake Team will review your application

You may be contacted for additional info or an interview

Approved applicants will receive placement instructions and move-in details

6. Stay Connected

Keep your phone or email available

Respond promptly to messages from GriffinHearts Transitional Housing

RESIDENT INTAKE FORM


Purpose

This form collects comprehensive information to support resident screening, placement, and program alignment. All information provided must be accurate and complete.

Personal Information

Current Housing and Release Information

Legal and Supervision Status

Background Information

Behavioral Health and Substance Use

Personality and Program Participation

Program Readiness

Strengths and Goals

(What do you want to achieve during your stay?) 

Agreements and Acknowledgments

I certify that the information provided is true and complete to the best of my knowledge.

Confidential by Design Reviewed with Care Processed with Purpose

This is a P

Contact:


+1 980-998-2985
[email protected]

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