Application and Screening Process

Most of our clients are referred by non-profits, nurses, social workers, case workers or even family members.

Admission Requirements

Meet Admission Requirements
Have a photo ID
Be willing to abide by house rules.
Must agree to a background check

Online Apply & Intake Interview

Fill out the online application and one of our intake staff will contact you.

After the intake form is submitted, a staff member will do an over-the-phone or video interview to answer any questions you may have or ask you any questions based on the information provided.

Move- In

Residents MUST sign a licensee agreement, pay the first month’s bed fee and a move in fee prior to moving in. Prospective residents are welcome to take a tour of the home prior to applying or moving in.
We accept SSI, SSDI, Veterans Benefits, private pay, payments from agencies or non-profits on behalf of residents and more. Residents are encouraged to enroll in a representative payee service prior to making payments.

After Move-In

Every home has a house supervisor responsible for holding weekly group meetings, overseeing the home and coordinating outsourced third-party services offered to residents. All house residents participate in the daily cleaning and maintenance of the home like washing dishes, and cleaning common areas.

Intake Form

Thank you for your inquiry regarding our independent living homes. All are rooms are shared but the request for a private room may be considered based on availability. We charge a monthly fee of $750 for shared bedrooms and a move-in fee of $350.

The move-in fee covers the cost of background checks, drug tests that may be done prior to residents moving in or anytime while living in the property, any damage they may cause to the property and vacancy time if they leave without prior notice. The move in fee is non-refundable.

At this time we are exclusively processing applications for men only and unable to accommodate couples, pets, women and families with children.

We have house rules that govern the safety of our residents and cleanliness of our homes. If you would like to know more about these rules prior to submitting an take form, you can request a copy here.

All residents must abide by these rules to maintain the peace and harmony in these homes.

Having a misdemeanor or felony is not an automatic reason for denial. Acceptance is based on a case by case basis.

First Name *

Last Name *

Other Names Used

Gender *

Date of Birth *

Current Address *

Phone Number *

Email Address *

What location are you applying for? Please select an option. *

How long would you like to be a guest at our home? *

Who is the application for? *

Other *

Funding Source *

Funding Source (Other) *

How much is the monthly income you receive? *

What is the specific date the payment is disbursed? *

Any additional income? *

Please disclose any existing medical conditions or health conditions you may have like hypertension, diabetes, high cholesterol, heart conditions, Asthma, high blood pressure, other. *

What medications are you currently taking? *

Have you been diagnosed or do you currently suffer from a mental illness like depression, anxiety, schizophrenia, mood disorders, bipolar or other? *

Are you currently taking any medications for this illness or illnesses? *

Are you a smoker? If yes, what do you smoke? *

Do you agree to do a drug test prior to move-in date? *

Do you agree to random drug testing while living in any of our homes? *

What is your primary means of transportation? *

Are you currently employed? *

What are your shifts/ hours and what city do you work in? *

Would you consider appointing a representative payee to ensure timely rent payments? If not, your rent will be due in advance to ensure good faith.

Any felony or Misdemeanor? *

When? *

Do you agree to a background check? *

Please provide details including criminal charges, convictions, and legal outcome

Date looking to move in:

Estimated Length of Stay:

Interest In *

Message

Upload attachments