North Carolina Coalition to End Homelessness

Balance of State CoC 2018 Point-in-Time Count Forms

Date of the Count

The 2018 Point-in-Time Count will be held the night of Wednesday, January 31, 2018. 

There are different forms for agencies that use HMIS and agencies that do not use HMIS. Emergency Shelter, Transitional Housing, and Rapid Re-Housing agencies that use HMIS should complete the form below and also run the HMIS PIT and HIC reports. Emergency Shelter, Transitional Housing, and Rapid Re-Housing agencies that do not use HMIS should only complete the form listed below. Permanent Supportive Housing agencies should only run HMIS PIT and HIC reports.

 

Instructions for HMIS Agencies

Agencies that use HMIS have specific instructions for each project, depending on the component type. Please refer to the training and guides in each section below to complete the required form and reports. Submit the forms and/or reports to NCCEH by February 21, 2018 through this 2018 BoS PIT & HIC Submission Form.

 

Sheltered Homeless Count Form

USE FOR: emergency shelters, seasonal shelters, transitional housing programs 

  

Rapid Re-Housing Count Form

USE FOR: rapid re-housing programs



Permanent Supportive Housing Count Form

USE FOR: permanent supportive housing programs

 

 

Instructions for Non-HMIS Agencies

Agencies that do not use HMIS should use the forms below to collect and report their PIT and HIC information. The forms should be submitted to NCCEH by February 21, 2018 through this 2018 BoS PIT & HIC Submission Form.

Sheltered Homeless Count Form

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

Form
Word form (fill out on computer)
PDF form (fill out by hand)
Training
  

Rapid Re-Housing Count Form

USE FOR: rapid re-housing programs

Form
Word form (fill out on computer)
PDF form (fill out by hand)
Training
Watch Training (10 min)

 

Unsheltered Homeless Count Form

USE FOR: recording each county's total unsheltered homeless count

Form

Word form (fill out on computer)
PDF form (fill out by hand)

Training Watch Training (13 min)


Point-in-Time Count Survey & Youth Addendum

USE FOR: interviewing homeless persons during the count to collect needed information 
  • These forms should be collected by the PIT lead for review and de-duplication of your region's count.
  • You may edit the Word version of the survey to add extra questions your community may wish to ask.
  • The Youth Addendum is an optional set of extra questions to gather additional information about homeless youth (people under age 25). This information does not need to be reported to BoS staff.
Point-in-Time Count Survey
Word form (editable)

Optional Youth Addendum
(additional questions for youth under age 25)

 

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 BoS staff. 
Form
Word form (fill out on computer)
PDF form (fill out by hand)
 

2018 Point in Time Count Trainings

PIT/HIC Webinar for Regional Committee PIT Leads 

Watch training (1 hour)

Tags: practice