HMIS Access Request Form

HMIS Access Request Form
Welcome to the HMIS Access Request Process for Sacramento & Yolo Counties

Supervisors from agencies participating in Homeless Management Information System (HMIS) can utilize this form to request, transfer, upgrade, and deactivate access for their employees (HMIS End Users). For more information about the HMIS Access Request Process, please visit our webpage.

Form Requirements: Please use work email addresses and phone numbers associated with the Supervisor's or HMIS End User's organization. This form is to be completed by supervisors or agency representatives, not the HMIS End User.

This form is intended for agencies already established in the Sacramento and Yolo County HMIS. New agencies interested in joining please visit our webapge to establish your agency in HMIS, New Agencies and Programs.
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Please select your role:*

Supervisor (submitting on behalf of the HMIS End User)Executive Director/CEO (submitting for yourself)Other administrative staff (submitting on behalf of the HMIS End User)
HMIS End User's Full Name*

First NameLast Name
HMIS End User’s Work Email Address*
HMIS End User’s Work Phone Number*
HMIS End User’s Supervisor Full Name*

First NameLast Name
HMIS End User’s Supervisor Email*
HMIS End User's Supervisor Phone Number*
Please enter a valid email address: This form must be completed by a supervisor or agency representive other than the HMIS End User as this form indicates what level of access the HMIS End User needs. Collecting essential information, such as the employee's correct name, work contact details, and required access levels, is crucial for setting up or upgrading their HMIS account effectively.
Please select your reason for submitting a HMIS Access Request*

My employee needs a new HMIS license.My employee needs to upgrade or change their HMIS access.My employee left our agency and needs their HMIS license deactivated.Other
Continuum of Care (CoC)*

SacramentoYolo
Primary Agency Access Name - Sacramento*
Please select the primary HMIS Agency the user will need to access in HMIS.
Primary Agency Access Name - Yolo*
Please select the primary HMIS Agency the user will need to access in HMIS.
If you selected "Other" for Primary Agency, please write in your Agency's name
Please note, if your Agency is not in the drop down selection, it may not be in HMIS yet.

HMIS Access Request Form
HMIS Access Role Descriptions

HMIS access roles enable or restrict viewing and editing rights for HMIS End Users. The majority of HMIS End Users have Direct Service Staff level access.
Below are the access roles to choose from:
- Direct Service Staff: Direct Service Staff is our most commonly used access level. Users are able to view/create/edit client records, program enrollments, services, assessments, contacts, locations, files, notes, and public alerts. They can also access the report library and run many of the canned and custom reports in the system.
- Services Only: This access role has very limited viewing access in HMIS. Other than viewing some of the information in the system, this access level can create services within active program enrollments, add notes, and add public alerts. They CANNOT complete assessments, refer clients, or enroll/exit clients from programs.
- Supervisory Access: Designed for users who supervise other staff. In addition to the abilities of someone with Direct Service Staff access, they also have limited rights to delete information in the system, access to reports that allow them to monitor staff activity, and the ability to create their own custom reports in the Data Analysis section.
- Reporting and Monitoring Only: This is a special access level for users who DO NOT enter or edit client program enrollments but are pulling report data to monitor the program's results. This access level allows the user to view all of the information for program enrollments, run both canned report and custom reports, and build and save their own data analysis reports.
Below are the access role upgrades to choose from:
- Upgrade to Direct Service Staff: This short assessment allows users to upgrade from Services Only to Direct Service Staff to allow access to assessments in HMIS.
- Upgrade to Supervisory Access: This brief assessment allows user to upgrade from Direct Service Staff to Supervisory Access.
Please select which access role your staff member requires below.*

Direct Service StaffServices OnlySupervisory AccessReporting and Monitoring OnlyOther
Please select which access role upgrade your staff member requires below.

Upgrade to Direct Service StaffUpgrade to Supervisory AccessOther

HMIS Access Request Form
HMIS User Deactivation
Thank you for your submission regarding this HMIS user who is no longer affiliated with your organization. We will deactivated their HMIS account within 24 hours, so they will no longer have access to the system. If you have any questions or need any additional assistance, please let us know.
Please select the date the HMIS User needs their license deactivated:

MonthDayYear
Date

HMIS Access Request Form
Next Steps
Once you submit this form, the HMIS End User's supervisor will receive a request to complete a Staff Verification Form and the HMIS End User will receive additional instructions from our HMIS Team. For more information about the HMIS Access Request Process, please visit our webpage or email the team at hmis@sacstepsforward.org.
Should be Empty:

HMIS Access Request Form

HMIS Access Request Form

Additional Agency Accesses

HMIS Access Request Form

HMIS Access Role Descriptions

HMIS Access Request Form

HMIS User Deactivation

HMIS Access Request Form

Next Steps