MSHMIS Assessment Forms

As of 10/1/2016, assessment forms will now be geared towards project types rather than specific funders, with special exceptions for VASH, SSVF, and youth providers. Please see the appropriate section below for your project to find the necessary forms.

Assessment Mapping Document


 Emergency Shelter (including ESP & ESG)

MSHMIS Street and Shelter Intake

MSHMIS Update

MSHMIS Exit

MSHMIS Universal Data Elements 3.917A Intake (Minimum Required Data Elements for Non-Funded Projects)


 Street Outreach (NOT Including Youth Providers - See Youth Section Below)

MSHMIS Street and Shelter Intake

Street Outreach Supplemental Form (Contacts & Engagement)

MSHMIS Update

MSHMIS Exit

MSHMIS Universal Data Elements 3.917A Intake (Minimum Required Data Elements for Non-Funded Projects)


 HARA Screening, Rapid Rehousing, and Prevention

MSHMIS HARA Screening

MSHMIS RRH and Prevention Intake

MSHMIS Update

MSHMIS Exit


 TH, PH, PSH, SSO

MSHMIS CoC Intake 3.917B

MSHMIS Update

MSHMIS Exit

MSHMIS Universal Data Elements 3.917B Intake (Minimum Required Data Elements for Non-Funded Projects)


 Youth

MSHMIS Youth Shelter Intake (3.917A) - BCP-ES

MSHMIS Youth Street Outreach Intake - SOP

MSHMIS Youth Basic Intake (3.917B) - All other project types

MSHMIS Youth Follow-Up Form (HYR Contract)

MSHMIS Group Brief Contact Record (HYR Contract)

MSHMIS Individual Brief Contact Record (HYR Contract)

MSHMIS Youth Update

MSHMIS Youth Exit

MSHMIS Youth Street Outreach Exit

Self-Sufficiency Matrix

Self-Sufficiency Matrix Training

Reunification Matrix

Reunification Matrix Training


 VASH

MSHMIS VASH Intake

MSHMIS VASH Update

MSHMIS VASH Exit


 SSVF

MSHMIS SSVF Intake

SSVF HP Screening

MSHMIS SSVF Update

MSHMIS SSVF Exit


Additional/Miscellaneous Forms

Case Management


 If you prefer to view any of these forms as a Word document, please click here.

                     Michigan Coalition Against Homelessness  |  15851 S.Old U.S. 27, Building 30, Suite 315 Lansing, MI 48906  |  Phone:  (517) 485-6536  |  Fax:  (517) 485-6682