Please complete this short pre-screen form to determine eligibility for our independent shared housing for male veterans age 62 and older.

This form helps us confirm discharge status, independence level, and voucher or funding readiness before scheduling a follow-up call. All information is kept confidential.

This program serves male veterans age 62 and older only.

This housing is for fully independent veterans. We do not provide medical supervision, or personal care services.

Case managers may submit this form on behalf of eligible veterans.

After we review your information, we will contact you to discuss eligibility, availability, and next steps.

Please note: We cannot accept veterans who require assisted living, medical supervision, or personal care services.