North Carolina Coalition to End Homelessness

2015 Point-in-Time Count Forms

The 2015 North Carolina Point-in-Time Count will be held the night of Wednesday, January 28, 2015. Please use the forms below to record and report your data from the count.

Forms that need to be submitted to NCCEH can be sent by email (preferred) or by fax to 1-888-742-3465.

Sheltered Homeless Count Form

USE FOR: emergency shelters (including domestic violence shelters), seasonal shelters, transitional housing programs 

  • Balance of State CoC communities: submit forms to NCCEH by Feb. 20. Agencies that use HMIS/CHIN must also submit their HMIS PIT report.
  • All other CoCs: submit forms to your local PIT coordinator.
Sheltered Homeless Count Form
Word form (fill out on computer)
PDF form (fill out by hand)
 

Unsheltered Homeless Count Form

USE FOR: street counts and services-based counts of unsheltered homeless persons

  • Balance of State CoC communities: submit forms to NCCEH by Feb. 20.
  • All other CoCs: submit forms to your local PIT coordinator.
Unsheltered Homeless Count Form     
Word form (fill out on computer)
PDF form (fill out by hand)
 

Rapid Re-Housing Count Form

USE FOR: rapid re-housing programs

  • Balance of State CoC communities: submit forms to NCCEH by Feb. 20. Agencies that use HMIS/CHIN must also submit their HMIS PIT report.
  • All other CoCs: submit forms to your local PIT coordinator.
Rapid Re-Housing Count Form     
Word form (fill out on computer)
PDF form (fill out by hand)


Permanent Supportive Housing Count Form

USE FOR: permanent supportive housing programs

  • Balance of State CoC communities: submit forms to NCCEH by Feb. 20. Agencies that use HMIS/CHIN must also submit their HMIS PIT report.
  • All other CoCs: submit forms to your local PIT coordinator. 
Permanent Supportive Housing Count Form
Word form (fill out on computer)
PDF form (fill out by hand)

Point-in-Time Count Survey

USE FOR: interviewing homeless persons during the count to collect needed information 

  • These forms should be collected locally for review and de-duplication of your count.
  • You may edit the Word version of this form according to your community's needs.
Point-in-Time Count Survey
Word document (editable)
 

Continnum of Care PIT Count Form

USE FOR: Continuum of Care leadership to report the CoC's total count to NCCEH. 

CoC PIT Count Form

Excel workbook
 

Imminently Homeless/At-Risk of Homelessness Form

USE FOR: optional counts of people who are imminently literally homeless or at risk of homelessness.

  • This form does not need to be submitted to NCCEH. 
  • Check with your local PIT coordinator to see if forms are being collected locally. 
Imminently Homeless/At-Risk of Homelessness Form
Word form (fill out on computer)
PDF form (fill out by hand)
 

2015 Point in Time Count Trainings

NCCEH held PIT Count webinar trainings on January 8, 2015. 

Presentation from Training for the Balance of State CoC

view pdf

Presentation from Training for Other CoCs (non-Balance of State)

view pdf