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 note: Staff will not 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.

Billing Period for HMIS License Year: June 1st - May 31st
Any new licenses bought during this billing year will be full-cost and need to be renewed come June 1st the following year.

Note: Licenses are not attached to people, but rather through the organization. No HMIS license should ever be shared. Each license can only be used by one user at a time.
Agency Name: *
Staff Requesting HMIS Access *
Work Email *
Has this individual been a licensed user on HMIS in Rhode Island within the last 12 months? *
What type of license is being requested? *
Submit
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