HOPE Baltimore Intake Form
Welcome to HOPE Baltimore!

HOPE is a re-entry service and advocacy organization that supports & empowers formerly incarcerated individuals as they naviage the transition from psiron to life outside. As a member of the HOPE community, you will be provided with resources to help you thrive in all areas of your life. Your success is the hope for others who will follow. 

The first step on your journey with HOPE is filling out this intake form. 
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Email *
Date *
How did you learn about HOPE?  *
What is your zipcode? *
Do you need expungement resources?  *
Do you have your birth certificate, social security card, or other forms of identification? 
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Do you have medical insurance? 
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Are you a high risk felon? Do you still feel you are a part of illegal convictions levels? Do high crime levels have you anxious?
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HOPE helps our clients address sytemic and personal barriers. For example, systemic barriers might include access to affordable housing and transportation, acquring job skills, and understanidng the job hunting process. Personal barriers might include addiction, isolation, family trauma, depression, and fear. 

Some other barriers include: living in an area where bus routes to get a job are over 2 hours both ways, lacking work history, being stigmatized by your past, needing help to fix or build credit, learning eletronic payment, owing outstanding bills for credit repair, do you have high blood pressure, asmtha, anger, mental crashes out emotional scars, abuse wounds from friends family or self

What are three barriers that directly affect you? You can name something not on the list above. 
Barrier One: *
Barrier Two:
Barrier Three:  *
Finally, please share three goals you want to achieve by participating with HOPE. 
As long as you are connected, service will be provided for 90 days - 6 months. 
Goal One:  *
Goal Two:  *
Goal Three:  *
Thank you for completing this intake form! You will get a copy sent to the email you entered above so you can use it during your journey with HOPE. 
A copy of your responses will be emailed to the address you provided.
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