Referral Form

Name

Phone

Email Address

Age

Branch

Referral Organization

Preferred move-in date

Current Housing Situation

Homeless

Temporary Housing

Other

Income

Employment

VA Benefits

Retirement

Is the client aware this is shared housing?

Yes

Program monthly fee: $1,100. Contact Leshelle Riddick if you have any questions: 980-998-3194.

Client Eligibility Criteria

The referred individual must be 18 years of age or older.
The referred individual must demonstrate the capacity to reside independently without direct supervision.
The referred individual must be capable of managing basic activities of daily living (ADLs) without clinical assistance.
The referred individual must be able to adhere to established community and household regulations.
The referred individual must possess sufficient income to meet the program's monthly fee obligation.
The referred individual must be actively seeking and committed to obtaining stable, long-term housing.
House The Nation does not operate as a medical or clinical care facility; individuals requiring medical supervision are not eligible.
The referred individual must be willing to fully participate in the formal intake and assessment process.

Reach out to us through our referral form. We focus on veterans and individuals on fixed incomes seeking safe housing.

We review the application and match the individual with a supportive, shared living environment that meets their needs.

Once approved, we facilitate a smooth move-in process to help our new residents feel secure and supported immediately.