HHRP
Today's Date
What step are you documenting?
Site Visit - Project Manager
Site Visit - Extra Details
Commitment Letter
Loan Closing/Contract Signing
Invoicing
Client
Program Engagement
AWARENESS - Site Visit
Legal First Name
Last Name
Which of these applies to you?
I have a primary address
I'm staying with family/friends
I'm currently staying in a shelter
I'm unhoused (not staying anywhere)
I'm not staying anywhere consistently
Other
Street
City
State
Zip Code
Country
AWARENESS - Site Visit Details
Birthday
Phone Number
Can we text you at this phone number?
Yes
No
Race
African American/Black
American Indian
Asian
Hawaiian or Other Pacific Islander
Caucasian/White
Biracial
Multiracial
I do not wish to answer
Other
Other Race
Number of people living in the home:
ENGAGEMENT - Commitment Letter
Notes
TAKING ACTION - Closing and Contract Signing
Number of Repairs:
Type of Repairs:
Concrete
Electrical
HVAC
Lead Repair
Masonry
Non Lead General
Porch
Radon
Roof
Windows/Doors
Notes
TRANSFORMATION - Invoicing
Number of Invoices:
Invoice 1 ($)
Invoice 2 ($)
Invoice 3 ($)
Invoice 4 ($)
Invoice 5 ($)
Invoice 6 ($)
Invoice 7 ($)
Invoice 8 ($)
Invoice 9 ($)
Invoice 10 ($)
Invoice Total:
Notes
PE ID
Client ID
Household ID
Contact Information