Print View

Your printed page will look something like this.

https://www.ncceh.org/2017pit-bos/

Balance of State CoC 2017 Point-in-Time Count Forms and Instructions

These forms and resources were created specifically for the count held in January 2017.
Please do not use them for the 2018 or future counts.

Instructions

The 2017 North Carolina Point-in-Time Count was held the night of Wednesday, January 25, 2017. Please use the forms below to record and report data from the count.

There are different forms for agencies that use HMIS and agencies that do not use HMIS. Agencies that use HMIS should complete the form below and also run the HMIS PIT and HIC reports. Agencies that do not use HMIS should only complete the form below.

Each Regional Committee's PIT lead must collect all forms from their region and check them for completeness and accuracy. The PIT lead should then submit the forms to BoS staff via an online submission form. The link to this submission form will be emailed to all PIT leads.

BoS staff are creating trainings on how to use the forms below. These trainings will be posted to this webpage in January.

Sheltered Homeless Count Form

USE FOR: emergency shelters (including domestic violence shelters), seasonal shelters, transitional housing programs

HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Non-HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Training	watch training (13 minutes)

Rapid Re-Housing Count Form

USE FOR: rapid re-housing programs

HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Non-HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Training	watch training (12 minutes)

Permanent Supportive Housing Count Form

USE FOR: permanent supportive housing programs

HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Non-HMIS Agencies	Word form (fill out on computer) PDF form (fill out by hand)
Training	watch training (10 minutes)

Unsheltered Homeless Count Form

USE FOR: recording each county's total unsheltered homeless count

Unsheltered Homeless Form	Word form (fill out on computer) PDF form (fill out by hand)
Training	watch training (13 minutes)

Point-in-Time Count Survey & Youth Addendum

USE FOR: interviewing homeless persons during the count to collect needed information

These forms should be collected by the PIT lead for review and de-duplication of your region's count.
You may edit the Word version of the survey to add extra questions your community may wish to ask.
The Youth Addendum is an optional set of extra questions to gather additional information about homeless youth (people under age 25). This information does not need to be reported to BoS staff.

Point-in-Time Count Survey	Word document (editable) PDF form
Optional Youth Addendum (additional questions for youth under age 25)	PDF form
Training	watch training (13 minutes)

Imminently Homeless/At-Risk of Homelessness Form

USE FOR: optional counts of people who are imminently literally homeless or at risk of homelessness.

This form does not need to be submitted to BoS staff.

Imminently Homeless/At-Risk of Homelessness Form

Word form (fill out on computer)

PDF form (fill out by hand)

2017 Point in Time Count Trainings

Intro to PIT/HIC for the Balance of State CoC (short pre-recorded training)	watch training
PIT/HIC Webinar for Regional Committee PIT Leads (held 12.8.16)	watch training