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Housing Program 

Participant Intake Questionnaire

Thank you for your interest in Wholelife Family Initiative’s Housing Program.

This questionnaire helps Wholelife Family Initiative understand your current housing situation, immediate needs, household circumstances, and goals so that we can determine what services, resources, referrals, or program opportunities may be appropriate.

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Completion of this questionnaire does not guarantee acceptance into a housing program, immediate housing placement, rental assistance, financial assistance, or any other specific service. Housing opportunities and assistance are subject to program eligibility, available resources, funding, capacity, and applicable program requirements.

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Please answer each question as accurately as possible.

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Housing is the starting point. Stability is the goal.

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