Reentry & Court Referral — Grace Haven Living + You and I Care Living
Home for the Holidays · Housing. Support. Stability. Together.
A joint referral to Grace Haven Living (housing) and You and I Care Living (care and support services). We respond within the hour.
Your name (referring officer or case manager)
*
Work email
*
example@example.com
Agency or court
*
Referring judge or docket
Please Select
Option 1
Option 2
Option 3
Referral type
Probation / parole
Reentry program
Specialty docket or court program
Release from jail or prison
Other
Client first name and last initial
*
Client email (so we can send the welcome and forms)
example@example.com
Expected release or move-in date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred area(s) for housing
Lyndhurst
Avon Lake
Brook Park
Cleveland (East Side)
Any area
Funding for the $750 monthly cost
Reentry or program funds
Client income
SSI / SSDI
Voucher
Not yet identified
Funding screen (yes/no, no case or health details)
Does the client have any income right now (job, benefits, or other)?
*
Yes
No
Not sure
Does the client have a disability, or already receive SSI or SSDI?
*
Yes
No
Not sure
Is the client a veteran?
*
Yes
No
Not sure
Was the client homeless before incarceration, or will they be homeless at release?
*
Yes
No
Not sure
Was (or will) the client be released from jail, prison or a halfway house within the last 12 months?
*
Yes
No
Not sure
Any supervision conditions that affect housing location? (general only, e.g. area restrictions)
Anything else we should know? (Do not include case or offense details.)
The client has agreed to this housing referral and to sharing their name and contact information with Grace Haven Living and its partner You and I Care Living.
*
I confirm
I understand Grace Haven Living provides room and board only, each applicant is reviewed individually under fair housing rules, and no payment or anything of value is given or accepted for referrals.
*
I acknowledge
referralSource
Submit Referral
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