• 2026 January Point in Time Count Form

    For Berkshire, Franklin, and Hampshire Counties

  • This is a Point in Time Count survey for the Three County Continuum of Care. This form should be used to survey persons who may not have had access to housing on the night of Sunday January 25th, 2026.

    This should only be used for people who were in Berkshire, Franklin, or Hampshire Counties on the night of Sunday January 25th, 2026. 

    Surveys can be completed between 10:00 PM Sunday January 25th through 11:59 PM Sunday February 1st. 

    Please answer as many questions as you comfortably can. Many of the questions are optional to respond to. This data helps inform our communities on how many people are experiencing homelessness and how much of a need there is for housing for special populations.

    Please contact Natalie Burtzos, CoC Compliance Manager at nburtzos@communityaction.us for questions about this survey.

  • Permanent housing - if you were in your own rental or home on Sunday July 20th, 2025, we cannot collect a survey response for you. Please double check the "Other situation" option to see if any situations listed in the follow up question apply. 

    If they do not, please stop here and do not submit the survey. Thank you for your participation!



  • If yes, please only continue if you plan to answer any questions you may have skipped last time.

    If you are not going to proceed, please exit the survey and do not submit any questions. Thank you!

  • These next few questions help our community determine how much of a need there is for housing for special needs or disabiliites.

    Please remember that you may choose "Prefer not to answer" to any answers you may not want to disclose.

  • Note: If this form is being filled out for a child, the health questions should be skipped.

  • Help us to not double-count you!

    We collect the following information only to make sure we don't count you twice, in case you are surveyed more than one time.

    We ask for the following infformation:

    • First letter of your first name
    • First 3 letters of your last name
    • Month you were born
    • Year you were born

  • Special Instructions for clients fleeing DV:

    Please use a coded ID based on "Anonymous."  For example, "Anon Adult 1," "Anon Adult 2," "Anon Adult 3," "Anon Child 1," etc.  Enter this information into the first field below.  Skip the next 2 fields.  

     

     

  • What month and year were you born?
    Month:       Year:   *      

    Example: Someone born December 1975 would be 12 -1975

  • Should be Empty: