• Housing Counseling Intake & Homebuyer Readiness Assessment

    Thank you for contacting GO Northwest Housing Resource Center. This intake form helps us understand your housing and financial goals and determine which counseling services best meet your needs. Based on your responses, you may be enrolled in one of the following programs: Fast Track Homebuyer Program, Financial Coaching Program, Foreclosure Prevention Counseling, Tenancy Assistance, or HpmeOwner Preservation Assistance. Please answer all questions as accurately as possible. Information collected is confidential and used solely for housing counseling and reporting purposes. Estimated completion time: 5–8 minutes.
  • Primary Housing Goal*

  • Client Information

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

  • Household Information

  • Marital Status*
  • Income Source (s)
  • Time receiving of Primary Income Source*

  • HUD Demographic Information

  • Race*
  • Ethnicity*
  • Veteran Status*
  • Disability Status (including Disabled Dependent)*

  • Housing Status

  • Current Housing Situation*
  • Length of Current Housing Situation*

  • Financial Information

  • Income Sources*

  • Credit Profile

  • Do you know your current credit score?*
  • Have you reviewed your credit report within the past 12 months?*
  • Current credit issues

  • Housing Triage Assessment

  • Desired Home Purchase/Home Refi Timeframe*
  • Are you required to get a certificate by a lender?*
  • Have you completed a Homebuyer/ Budgeting Personal Finances Education Course in last 12 months or before you purchased?*
  • Received Pre-approval letter from a Lender in last 4 months?*
  • Biggest Concerns About Buying a Home*
  • Intake Date
     - -
  • Should be Empty: