• Gentle Helpers Connections Placement & Referral Agency

    Chicago-Based Structured Housing Navigation

  • Independent & Co-Living Housing Referral Prescreening Application

    (To determine if you are housing placement ready)

  • SECTION 1: REQUIRED ACKNOWLEDGEMENT

    Please Read Before Continuing Gentle Helpers Connections coordinates referrals for housing-ready adults seeking independent living or co-living housing programs within our participating provider network. Housing opportunities are considered based on current provider availability, affordability, move-in readiness, applicant preferences, and each housing provider’s individual eligibility and screening requirements. Gentle Helpers Connections does not provide emergency housing, shelter placement, crisis services, rental assistance, or guaranteed housing placement. We also do not guarantee that an appropriate housing opportunity will be available when you apply. Submitting this prescreening application does not place you on a housing waitlist, reserve a housing opportunity, or guarantee approval, referral, acceptance, or placement. Applications are reviewed based on the housing opportunities available within our provider network at the time of review. If a potential housing option becomes available that appears to match your stated needs, budget, and eligibility, Gentle Helpers Connections may contact you regarding possible next steps. Final screening and acceptance decisions are made independently by the housing provider. Please provide complete, accurate, and verifiable information. Missing, outdated, inconsistent, or unverifiable information may delay or prevent further review.⚠️ Submit Only One Application. Please submit only one application per person. Duplicate applications—including applications submitted using different phone numbers or email addresses—may delay processing and may be removed from review. If you have already submitted an application, do not submit another application simply to provide updated information. Contact our office directly to update your existing information. Applications are primarily tracked by phone number, so please notify us if your phone number, email address, income, housing situation, preferred location, or other important information changes. Gentle Helpers Connections Placement & Referral Agencyinfo@gentlehelpershomecare.com (312) 801-5277 (voice mail only)
  • 1. Required Acknowledgement (Checking All three boxes which are mandatory for application review and processing)

  • SECTION 2: Applicant Information

  • 3. Date of Birth*
     - -
  • Format: (000) 000-0000.
  • 6. Gender*

  • SECTION 3: Supervision & Legal Status (Justice Impacted)

  • 7a. Current Supervision Status*
  • 8. Are there curfews or visitor restrictions?

  • SECTION 4: Housing Needs & Preferences

  • 10. Do you have children which will live with you?*
  • 12. Preferred Housing Location (Check all that apply)*
  • 13. Monthly Housing Budget*
  • 14. Room Preference*

  • SECTION 5: Income & Stability

  • 15. Primary Income Source*
  • 17. Can rent be paid consistently on a monthly basis?*

  • SECTION 6: Additional Housing Screening

  • 18. Do you have any mobility or accessibility needs that may affect housing placement? (This question is used only to help identify housing options that may be physically appropriate. It does not guarantee accommodation or placement.)*
  • 19. Smoking Status*
  • 20. Any pets?*
  • 20. Any substance-related housing restrictions we should be aware of?*

  • SECTION 8: Acknowledgement

  • 23. Acknowledgement Statement

    I understand that Gentle Helpers Connections is a housing placement and referral agency and does not own, operate, or manage housing. Submission of this form does not guarantee housing placement. All housing decisions are made by independent housing operators based on their criteria, availability, and approval processes.

  • 24. Date*
     - -

  • Closing Notice

    Thank you for completing the Housing Readiness Intake. Submission does not guarantee placement. Availability depends on openings with private landlords and independent housing providers.  
  • Should be Empty: