HMIS New User Request Form
It is important to the Rhode Island Coalition for the Homeless to ensure all HMIS processes and procedures are streamlined. When a volunteer or staff member in an already-participating RI-HMIS organization is in need of HMIS access, this form should be completed. If you are not a participating RI-HMIS organization, please contact hmis@rihomeless.org for more information.

Please complete the following survey, as it will go directly to our HMIS team at HMIS@rihomeless.org.

Please note: No user will be granted HMIS access until confirmation that the organization requesting a license has paid for said license. If you would like a staff member to replace the pre-existing access another staff member may have, you can indicate that in this form. If there is more than one user on HMIS that no longer need/use the system and you’d like to free up that license, please contact the HMIS team at the email listed above.

2019-20 HMIS LICENSE COSTS:
$627.00 per new license (paid annually)
$405.00 per renewed license (if license was bought NEW in prior FY's and only renewing licenses from the last year) (paid annually after the initial new license fee).

Billing Period: June 1, 2019 through May 31, 2020. Any new licenses bought during this billing year will be full-cost and need to be renewed come June 1, 2020. Prices for 2020-21 HMIS licenses are not yet finalized yet. We are presently going through an HMIS Vendor RFP process, so if we do select a new vendor (or undergo a different contract with our current vendor) prior to May 2020, there may be additional charges to HMIS licenses this upcoming year. All users and agency administrators will be notified this Fall of any changes.

(Note: Licenses are not attached to people, but rather through organization. No HMIS license should ever be shared, so each license can only be used by one user at a time. For example, if Sally Smith is using an HMIS license and leaves her organization and the same organization hires Jonny John to cover Sally's previous position, then Sally must be removed from HMIS (as of the date she left) and the HMIS team can re-assign the license to Jonny. )
Please share your organizations' contact information below.
House of Hope
Organization *
Your answer
Mailing Address (Address, City, State, Zip Code) *
Your answer
Full Name of Person Requesting License *
Your answer
Title of the Person Requesting License *
Your answer
Contact Phone Number for Person Requesting License *
Your answer
Email Address of Person Requesting License *
Your answer
Is the person requesting the license the Agencies' HMIS Administrator? *
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