YHDP Diversion Partner Agency Referral Form

YHDP Diversion Partner Agency Referral Form
Diversion: Diversion focuses on helping individuals or families who are currently experiencing homelessness or are on the brink of entering homelessness (e.g., will have no safe place to sleep tonight) identify immediate, safe, and appropriate housing alternatives outside of the homeless response system. The goal is to prevent them from entering shelters or sleeping unsheltered by resolving their housing crisis quickly and sustainably.

Prevention vs. Diversion: Prevention aims to assist individuals or families who are at risk of becoming homeless in the near future but are not yet without housing. Diversion, by contrast, works with those who are already facing an immediate loss of housing or homelessness, focusing on immediate solutions to avoid shelter entry.
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Referring Agency Name
Staff Member's Name
Staff Member's Email
example@example.com
Client First and Last Name

First NameLast Name
Client's Phone Number and/or Email
HMIS# of Client
How long has the client experienced homelessness?
Since you selected 90 days or more, can you provide information on the situation?
Age Range of Client
Is the client residing in Oklahoma City limits?
Is the client seeking shelter tonight, and do they meet HUD's specific definition of literal homelessness?

When you submit this form, your information will be provided to a case manager who will contact you shortly.

Unfortunately, your client does not qualify for diversion at this time.

Please seek other resources by calling 211.
Should be Empty: