New User Request

New User Request
Each organization using HMIS has an assigned HMIS/Comparable Data Quality Officer, who serves as the agency’s primary point of contact for data quality, accuracy, completeness, and reporting. They are also responsible for submitting all HMIS New User Requests. Only the assigned HMIS Data Quality Officer should submit this request to Housing Forward. If you are unsure who this person is for your agency, please submit a help desk ticket to Housing Forward's Data Management & Reporting team at help@housingforward.on.spiceworks.com to avoid delays or rejected requests. Please note that view-only access to HMIS is not permitted.
Please select your organization:
Selected Organization*
Organization Not Listed
Training Process
This form should only be submitted by the HMIS/Comparable Data Quality Officer designated at your organization. If a submission is received by someone other than the agency's HMIS/Comparable Data Quality Officer, the request for training will be rejected and training delayed until your agency's HMIS/Comparable Data Quality Officer submits the proper request.
- Name of User*
  
  First NameLast Name
- Employment Start Date*
  
  MonthDayYear
  Date
- Antipicated HMIS Training Start Date*
  
  MonthDayYear
  If HMIS training is not completed within 2 weeks, they may be asked to restart the process.
- User's Agency E-mail*
  This must be an individualized agency email address.
- User's Phone Number*
  What is the best way to contact this person if something changes?Format: (000) 000-0000.
- User's Title *
- HMIS Project User Needs Access To:*
  List the name of project(s) as they are listed in ClientTrack. e.g. ASC - Emergency Shelter (ES E/E)
- User's Office Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- No.Yes, but this user only needs access to the new account.Yes, but this user needs access to both organizations.
- Supervisor Email *
  Supervisor will be notified of training progress updates
- Please select the appropriate role(s) and database access for this user.
  
  For protection of all client data, database administrators ask that users have access to only what is needed to perform their jobs. Answering all questions accurately ensures users receive proper training and system access. We do not allow view-only access to HMIS.
- Limited - End user will ONLY have the ability to record services and case notesHMIS Programs - End user will have full access in HMIS to record services and case notes, create enrollments, other assessments, and have access to reportsHMIS Programs + Custom Reporting - End user will have full access in HMIS to record services and case notes, create enrollments, other assessments, and have access to custom reports
- Coordinated Entry (CAS)Day ShelterEmergency ShelterHomelessness PreventionPH - Permanent Supportive Housing (disability required for entry)PH - Permanent Supportive Housing (NO disability required for entry)PH - Rapid Re-HousingSafe HavenServices OnlyStreet OutreachTransitional HousingPadmissionOther
- Access Point (Emergency Shelter, Street Outreach, etc.)Housing Provider (PSH, TH, RRH)
- Flex Funds (How to request funds)Rental Administration
- I verify, in coordination with the agency’s HMIS/Comparable Security Officer (SO), that the computer system setup for this user meets all requirements, including firewall configuration, virus protection, completion of a full system scan, and use of an approved web browser. I approve and accept responsibility for this user’s access to the HMIS shared client information system. I attest that once this user no longer requires access to the HMIS system, I will notify the HMIS Team through the service request tool to have the user’s access removed.
- Data Quality Officer*
- Today's Date*
  
  MonthDayYear
- Data Quality Officer Email*
  You will receive a copy of this submission form.
- Data Quality Officer Signature*
  
  Clear
- Should be Empty:

New User Request

Please select the appropriate role(s) and database access for this user.