Guidingneighborsinc

Intake & Roomate Matching Form
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Gender
Number of roommates Preffered
Cleanliness Preference
Noise Preference
Sleep Schedule

Accessibility & Housing Needs

Accessibility Requirements (Select all that apply)

Disability & Program Eligibility

Disability Status
Are you enrolled in Self-Direction?
Do you have a Section 8 Voucher?

Demographic Information

Race (Select all that apply)
Veteran Status
Elderly (62+)
Smoker

Roommate Match Questions

Any Prior Evictions?
Willing to Complete a Background Check?