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+1 (210) 767-9598

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Referral / Professional Intake

Who are you completing this housing request for?

Are you a case manager, social worker, agency, organization, or other professional making this referral?

Organization / Agency Name

Referral Contact Full Name

Referral Contact Phone Number

Referral Contact Email

Applicant Contact Information

Applicant First Name

Applicant Last Name *

Best Phone Number *

Email Address

Preferred Contact Method *

Housing Need and Location

When is housing needed? *

What type of housing are you interested in? *

Furnished Room Private Room Shared Room Shared Living / Co-Living Transitional Housing Short-Term Housing Long-Term Housing Other

Preferred City, Area, or ZIP Code

Are you open to nearby areas if housing is available? *

How many people need housing?

Maximum monthly housing budget *

Payment / Assistance Information

How will housing be paid? *

Employment Income Social Security / SSI / SSDI Veterans Benefits Agency / Nonprofit Assistance Housing Assistance / Voucher Family / Friend Support Savings Other

Is an agency, organization, program, or third party helping pay for housing? *

Program / Organization Name

Program Contact Name

Program Phone Number

Program Email

Housing Preferences and Accessibility

Which room arrangement would you consider? *

Do you need furnished housing? *

Are you comfortable living in a shared-home environment? *

Are you willing to follow reasonable house rules? *

What is important about the housing location?

Near Work Near Public Transportation Near Medical Services Near Family Near School Near Support Services Safe Neighborhood Other

Transportation

Please Select I Have Transportation Public Transportation Transportation Assistance No Transportation Other

Will any animals be living with you? *

Please provide basic information about the animal(s).

Is there anything about the housing itself that we should consider when trying to find an appropriate placement?

Referral Source and Additional Notes

How did you hear about Find Housing Now? *

If someone referred you, who referred you?

Is there anything else we should know to help identify an appropriate housing option?

Consent and Confirmation *

I agree that Find Housing Now may contact me by phone, text, or email regarding my housing request, housing availability, and potential placement options.

Information Confirmation *

I confirm that the information provided is accurate to the best of my knowledge.

Company Contact Information

Find Housing Now

Our Website *

www.findhousingnow.com

Our Email

info@findhousingnow.com

Our Phone Number

+1 (210) 767-9598

Find Housing Now connects housing seekers, referral professionals, and property owners with clear, independent housing solutions.

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info@findhousingnow.com
+1 (210) 767-9598
San Antonio, TX

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