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DOH Statewide Connecticut COVID 19 Homeless Response Assessment

In response to the Declaration of Public Health and Civil Preparedness Emergency enacted by Governor Lamont on March 10, 2020, we have created this data collection form to assess the preparedness needs of shelters, transitional housing, and drop-in centers pertaining to the anticipated spread of COVID-19. Please respond to the questions in this form with the best available information about your project.

DOH will be updating shelters regularly as new information emerges as providers enter a state of prevention and preparedness in response to the COVID-19 virus.  We recognize that some of these measures seem extraordinary, but our hope is that our efforts now will result in greater safety for all of us and the clients we serve.
1. Please provide the information below, so that you can be contacted if follow-up is necessary. *This question is required.
This question requires a valid email address.
2. Who can be served by your project/facility? *This question is required.Please select all that apply.
This question requires a valid number format.