Housing application

Start the path
to stability.

Use this form to apply for yourself or refer someone to Angels of Hope structured recovery housing.

Our intake team will respond within 24–48 hours.

Before you begin

Angels of Hope cannot accept individuals required to register under California Penal Code 290 or individuals with convictions under Penal Code 288. Submitting this form does not guarantee placement.

1. Referral2. Applicant3. Needs4. Consent

01 Who is completing this form?

Choose one. The application will show the questions relevant to you.

Parole / Probation Officer SUD Counselor / Case Manager Self-Referral Other Referral Source

02 Applicant information

Full legal name Date of birth Phone number if available Email address Medi-Cal CIN / ID number if available Current housing status Preferred county placement

Has the applicant been released from jail or prison within the past three years?

YesNoUnknown

Does the applicant have a CDCR number?

YesNoUnknown

Start the pathto stability.

Start the path
to stability.