HNHousing > Homeless Prevention Services > By-Name List

By-Name List

Homeless Prevention Services

If you are currently experiencing homelessness or are at risk of losing your housing, we may be able to prioritize you for various services in Haldimand and Norfolk.

The By-Name List (BNL) is an up-to-date list of all individuals and families experiencing homelessness in the Haldimand Norfolk area.

The goal of the BNL is to match homeless individuals and families to appropriate housing support services based on their unique needs. People identified as being at the greatest risk are offered available housing services and support first. When housing options are not readily available, the Social Services & Housing staff will explore other existing services and supports to help keep people safe while looking for housing solutions.

If you are currently experiencing homelessness, it is imperative you complete the referral form below to be included on the BNL for prioritization for any/all services and support for temporary or permanent housing or rehousing. If you need assistance in completing this form, please contact us.

Once you complete the information below, a staff member from the Social Services & Housing staff will contact you as soon as possible to confirm your circumstances and will make every effort to connect with you monthly after that.

To ensure we can stay connected to you please provide a working phone number or a contact number where messages may be left for you. We will make every effort to connect regularly with you, please help us help you. You can expect to hear from someone within 14 business days of submission of this form.

If you have any questions regarding this information or Homeless Preventions Services available in Haldimand and Norfolk please contact the Homeless Prevention Services Intake line at

519-426-6170; 905-318-6623; 519-582-3579 Ext. 3134 or email us [email protected]

By Name List

Name
(mm/dd/yyyy)

Are you currently in:

Location
(mm/dd/yyyy)

Status in Canada

Is it a…
Text?Wifi
Is this number yours?
Do you provide consent to leave messages with this contact?

Has someone assisted you in completing this form, or do you have any other support people we may communicate with on your behalf?
Name

Location/ Dates/ Times

Do you fall into one of the following provincial priority groups? (please check all that apply)

Where are you staying tonight and/or where did you stay last night?

I understand that the Social Services & Housing will have access to my information on the By Name List.</li> <li>I understand that Housing staff may contact me to tell me about housing and support services when they become available.</li> <li>I understand that I can contact Homeless Prevention Services if I would like my name to be removed from the By-Name List at any time
I understand that the Social Services & Housing staff will have access to my information on the By Name List.
  • I understand that Social Services & Housing staff may contact me to tell me about housing and support services when they become available.
  • I understand that I can contact Social Services & Housing staff if I would like my name to be removed from the By-Name List at any time

    • Third party consent
    I understand by consenting to be included on the BNL my information may be shared with community partners with services I am seeking, to contact me.

    By signing or indicating below, I give permission for Haldimand-Norfolk Homeless Prevention Services to add my personal information to the HNHSS By-Name List.(Required)
    By signing or indicating below, I give permission Haldimand-Norfolk Homeless Prevention Services to add my personal information to the HNHSS By-Name List. I understand that the following information will be added to the By Name List: Name and date of birth; the score of the VI-SPDAT assessment (if completed); the current state of housing; contact information.