Intake & Eligibility

Thank you for your interest in our independent housing program. This form helps us collect the information needed to provide you with a safe, secure, and comfortable living environment. Please complete all sections accurately. The information you provide will be kept confidential and is used solely to determine eligibility, assign housing, and maintain a well-managed residential community.

This program provides housing only. It does not include assisted living, medical care, personal care, supervision, or case management.