Housing Exit Form

Please use this form to record whenever an individual or family leaves permanent housing. To avoid duplication, the housing provider should complete this form whenever a client moves out. For all other placements, the Client Navigator or other staff working directly with the client may complete this form. To help capture all clients leaving permanent housing and determine the percentage of all housing placements going through the Coordinated Assessment and Housing Placement System (CAHP), please complete this form even for clients who were not matched through this system.

    A. Contact Information

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    B. Client and Housing Exit Information

    Please complete this section to confirm the exist of a client from a unit.
    This is a required question
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    This is a required question