COHMIS Bed/Voucher Inventory Setup Form
This form serves two purposes—confirming adequate setup of projects in HMIS, which will then be used to generate the Housing Inventory Count (HIC) which is submitted to the U.S. Department of Housing and Urban Development (HUD). This form must be filled out for Emergency Shelters, Permanent (Supportive) Housing, Transitional Housing, and Rapid-Rehousing programs.
ONE FORM PER PROGRAM, PLEASE
Name
*
First Name
Last Name
Email
*
example@example.com
Program Name
*
Housing Inventory Start Date
*
-
Month
-
Day
Year
Date
Housing Inventory End Date (if applicable)
-
Month
-
Day
Year
Date
Bed Type
*
Please Select
Facility-based (Beds including cots or mats located in a residential homeless assistance facility dedicated for use by persons who are homeless)
Voucher (Beds located in a hotel or motel and made available by the homeless assistance project through vouchers or other forms of payment)
Other (located in a church or other facility not dedicated for use by persons experiencing homelessness
Bed Availability
*
Please Select
Year-round
Seasonal
Overflow
Do you have beds/vouchers dedicated to Youth or Veterans?
*
Yes
No
Number of beds/vouchers dedicated to youth who are Veterans (if applicable)
Number of beds/vouchers dedicated to any other youth (if applicable)
Number of beds/vouchers dedicated to any other Veterans (if applicable)
Number of non-dedicated beds/vouchers (beds for any type of client)
*
Total bed/voucher inventory
*
Total unit inventory (for Housing Programs)
How many total beds/vouchers are for HOUSEHOLDS WITH ONLY ADULTS (enter "0" if not applicable)
*
How many total beds/vouchers are for HOUSEHOLDS WITH AT LEAST ONE CHILD (enter "0" if not applicable)
*
How many total beds/vouchers are for HOUSEHOLDS WITH ONLY YOUTH (enter "0" if not applicable)
*
Submit
Should be Empty: