Housing Referral Form

Please DO NOT make this referral if client is unaware of referral and if she is unaware of the specific services that GEMS provides.

In order to complete the Housing Referral, please follow these steps:

  1. Complete entire referral form in print or type. Attach additional paper if needed.

  2. Attach the following documents to this referral:

    1. Proof of negative PPD text within last 6 months.

    2. Completed mental health evaluations/psychosocial reports.

    3. A short written statement by the client as to why they feel that the GEMS program is appropriate for them and what they hope to accomplish/achieve while in the program.

  3. Email the completed referral to mikell@gems-girls.org and lindab@gems-girls.org. You will be notified if referral is accepted or not. Staff will contact you regarding next steps and/or initial appointments.