WDRC Housing Stability Intake
Our Housing Stability program was created to help tenants and housing providers resolve rent, lease issues, relocation plans, maintenance/cleaning, disagreements between housemates/neighbors, and more.

Click HERE to learn more from our blog about what Housing Stability mediation is and how it could help you!

This confidential intake form is intended for tenants, property managers, landlords, housemates, neighbors, case managers, and/or attorneys to tell us more about the situation and your goals. We appreciate your time in providing this information to us whether or not you are interested in mediation.

Case managers, attorneys, and other support persons: Please answer from your own perspective, and provide information regarding the person that you support/represent when prompted. We recommend verbally confirming the person's permission to share this information with WDRC before completing this form. We do not require a formal Release of Information with this form, but may require one later if you become involved in the person's WDRC services ongoing.

Completing this intake form does NOT commit you to accepting our services or attending a mediation session. After receiving your response, a Housing Stability team member will contact you to share more about the mediation process and better understand how you want to move forward.

Your responses to this form, and any other information you share with your Housing Stability case manager, will NOT be shared with the other party or anyone outside our office without your permission.
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Email *
Information about you
Please tell us how to contact you and any other preferences you may have. If you are completing this form on behalf of another person, please answer the optional questions below regarding that person's information and contact preferences.
Your first and last name: *
Your phone number: *
Your mailing address:
Your primary language: *
Please choose or write the language in which you want to receive services.
Por favor elija o escriba el idioma en el que desea recibir los servicios.
Пожалуйста, выберите или напишите язык, на котором вы хотите получать услуги.
ਕਿਰਪਾ ਕਰਕੇ ਉਹ ਭਾਸ਼ਾ ਚੁਣੋ ਜਾਂ ਲਿਖੋ ਜਿਸ ਵਿੱਚ ਤੁਸੀਂ ਸੇਵਾਵਾਂ ਪ੍ਰਾਪਤ ਕਰਨਾ ਚਾਹੁੰਦੇ ਹੋ।
Required
Are you starting a new request, or responding to WDRC's request? *
Please note that completing this form does NOT commit you to attending a mediation session.
What is the best way to contact you?
Please select your preferences.
When are the best days/times to contact you?
How can the WDRC be more accessible to you?
Please describe any accommodations regarding how to contact you, how to include you in meetings, or anything that would make our services easier for you to use.
How did you hear about WDRC Housing Stability services?
Would you like to subscribe to our WDRC Housing Stability newsletter?
Your answer to this question DOES NOT affect the level of priority of your case, or the service(s) that we may provide to you. If you answer yes, our staff will add your name and email address to our WDRC Housing Stability newsletter recipient list.
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If completing this form on behalf of another person (your client, friend, family member, etc.), please write their name and preferred contact information here.
If the person has not given permission to share their identifying information with WDRC, you may instead write their relationship to you, e.g. "client" or "friend." If the client is a business, please provide the name of the business.
If completing this form on behalf of another person, please confirm their permission to share their identifying information and be contacted by our office.
If you have a completed Release of Information form, you may email it to housing@whatcomdrc.org or fax it to 360-676-0783.
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