All of the following forms must be completed and submitted to be considered for the Accessible Housing Program (AHP):
►Accessible Housing Program Application
► Intake Form (if you’re not already an Independence, Inc. consumer with an intake on file)
► Release of Information consent form
► Signed HIPAA acknowledgement form (return signature page only)
Along with your application, you MUST submit the following in order to be considered for the AHP:
► Proof of income for everyone in the household age 18+ that has ANY form of income to report (income must reflect previous 6 month period)
► Signed Landlord Agreement if home is a rental (located on page 2 of the application)
Read/download/print the following information we are required to share – acknowledgement of receiving this information must be marked on page 2 of the application:
► Accessible Housing Program information sheet
► Consumer Rights and Grievance Policy & Procedure
Questions? Contact Daniel Brown, Core Services Manager
► Call 785-841-0333 ext. 121