Rematch Request: Asking for an additional match for a previously reported unit/bed opening
Please fill out this form in its entirety to request an additional match for a previously reported unit/bed opening. The original match would have been sent via HMIS, but the client was found to be ineligible for the project or unable to be contacted for engagement. Please have the HMIS Client ID number available for the client that was ORIGINALLY matched to your project.

Once you submit this form, you will hear from us within two business days with a new match for your current opening.

If you have any questions, please email ChicagoCES@CatholicCharities.net.

Email address *
Agency Name: *
Project Name: *
Project Contact Person: *
Your answer
Project Contact Person email address: *
Your answer
Type of housing program: *
Date of opening (as previously reported): *
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DD
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Please indicate the unit size for this rematch request: *
Is the unit wheelchair accessible? *
Does your HUD contract require that this unit is dedicated to a household facing chronic homelessness? *
HMIS ID of Client sent for previous match: *
Your answer
Need Status of Initial Referral: *
Please ensure that the Need Status in HMIS matches the Need Status selected above
If a "CES: Rematch Needed: Ineligible" option was chosen above, please select reason: *
If you selected "Other" above, please explain why the household was not eligible:
Your answer
If "CES: Rematch Needed: Client declined to participate" was chosen above, please select reason: *
If you selected "Other" above, please explain why the household declined:
Your answer
If your rematch request is due to the previous household not experiencing chronic homelessness, please be sure to upload the Chronic Homelessness Verification Packet into to Head of Household's HMIS Client Profile and answer the question below.
You can access the Chronic Homelessness Verification packet here: http://www.csh.org/wp-content/uploads/2018/01/CoC-Chronic-Homelessness-Verification-Packet-and-Procedures_2018.pdf

You can access instructions for uploading the packet here: www.tinyurl.com/chicagochverify

On what date did you upload the Chronic Homelessness Verification Packet into the Head of Household's HMIS Client Profile?
MM
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DD
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YYYY
Is this request for a HOPWA-funded unit? *
Is there any additional information we need to know?
Your answer
Youth TH 2:1 Matching Pilot
Please only answer the following if you are participating in the Youth TH Matching Pilot (Heartland Neon Street, ChildServ, New Moms)
HMIS ID of second Client sent for previous match:
Your answer
Need Status of Second Referral:
Please ensure that the Need Status in HMIS matches the Need Status selected above
If a "CES: Rematch Needed: Ineligible" option was chosen above, please select reason:
If you selected "Other" above, please explain why the household was not eligible:
Your answer
If "CES: Rematch Needed: Client declined to participate" was chosen above, please select reason:
If you selected "Other" above, please explain why the household declined:
Your answer
A copy of your responses will be emailed to the address you provided.
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