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FUTURE SERVICES INTEREST FORM

Better Housing Solutions is currently in the planning and development stage and is not yet providing direct services. This form allows individuals and families to express interest in future BHS programs and helps us better understand community needs.


Submitting this form does not constitute an application for services, guarantee future placement of eligibility, or create a service relationship with Better Housing Solutions.

Relationship to Individual Interested in Services
Preferred Method of Contact
Email
Phone
Either
About the Individual
Age Range
Under 18
18-21
22-30
31-40
41-50
51-60
61-70
71+
Which future BHS services are you interested in learning more about?
Which service is your highest priority right now?
What is the biggest challenge you or your family currently face when looking for services or support?
When do you anticipate needing services?
As soon as services become available
Within 1 year
Within 2-3 years
Within 4-5 years
More than 5 years from now
Planning for the future / unsure
Would you like BHS to contact you when information becomes available about future programs or services?
Yes
No
Would you like to receive general BHS news, events, and updates?
Yes
No

Please Note: Better Housing Solutions is not currently providing direct services or accepting applications for housing, transportation, day services, respite care, or residential services. This form is for planning and informational purposes only. Submission does not guarantee eligibility, enrollment, placement, or future services.

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