Coordinated Entry Assessment and Prioritization Form

This form is designed for HUD Continuum of Care access points, outreach teams, shelters, and coordinated entry staff who need to assess households for housing prioritization. It works best when one trained assessor completes it consistently across clients. If your program does not use coordinated entry or prioritization, this template may be more detailed than you need. It is also useful for documenting why a household was matched to a specific intervention.

It collects assessment context, household composition, homelessness history, disability and health documentation, vulnerability indicators, housing preferences, and the final prioritization recommendation. The fields are structured to support conditional logic, so you only ask follow-up questions when a prior answer makes them relevant. That helps reduce unnecessary PII collection and keeps the interview focused. It also creates a clearer audit trail for later review.

Most programs complete it at intake, at reassessment intervals, and whenever a household’s circumstances change enough to affect prioritization. Some access points also use it when a referral is being reconsidered after a missed appointment or new documentation is received. The exact cadence should follow your local coordinated entry policy and HMIS workflow. A common pitfall is treating the form as one-and-done when vulnerability and housing status can change.

Because this template collects disability, health, safety, and homelessness information, it should be used with clear consent language, data minimization, and role-based access. Only collect what you need to determine eligibility, prioritization, and referral, and avoid free-text fields that invite unnecessary PII. If you store the form in HMIS or another system, make sure your process supports an audit trail and aligns with local CoC requirements. For accessibility, the form should meet WCAG 2.1 AA expectations and use progressive disclosure for sensitive follow-up questions.

Customize the priority level, recommended intervention, and scoring fields to match your local CoC policy, vulnerability index, or project-specific referral rules. You can also add conditional logic for veteran status, chronic homelessness, disability verification, or safety concerns if those factors affect ranking in your community. Keep the recommendation field separate from the raw assessment data so reviewers can see both the inputs and the final decision. Avoid hard-coding assumptions that do not match your local written policy.

The most common mistakes are marking every field required, asking for more detail than the program needs, and skipping the consent step before collecting sensitive information. Another frequent issue is using one large text area instead of structured fields for dates, counts, and yes/no indicators. Programs also sometimes fail to document why an immediate safety action was taken or what follow-up is scheduled. Those gaps make the prioritization harder to defend later.

Yes. The form is a good fit for HMIS intake, referral tracking, case management notes, and coordinated entry queues because it separates assessment data from next-step actions. You can map fields like client ID, assessment date, priority level, and referrals made into downstream systems. If you use integrations, keep the source of truth clear so staff do not enter the same information in multiple places without a reason. That reduces duplication and improves data quality.

An ad hoc interview often misses key fields, asks questions in an inconsistent order, and produces notes that are hard to compare across households. This template standardizes the assessment so staff capture the same core data every time, with room for conditional follow-up where needed. That improves fairness, reviewability, and handoff quality between access points and housing providers. It also makes it easier to explain why one household was prioritized over another.