Point in Time Count Forms

The following forms are to be filled out for anyone who, on the night of January 31, is staying in an unsheltered location, in a motel paid for with a GA motel voucher, in a domestic or sexual violence shelter, or in another emergency shelter that does not input data into the VT Homeless Management Information System (HMIS). The forms collect basic demographic and homeless status information; they do not collect any information that is personally identifying. You can also view the forms on the PIT Count section of the VCEH website.

The electronic form, which is new this year, will allow for more timely and accurate data. It is easy-to-follow and can be filled out on any smartphone, tablet or computer that has access to wifi/data.

The DEMO version should be used for practicing and familiarizing oneself with the survey in the days leading up to the Count. LIVE versions will be posted on the VCEH website and sent out on the VCEH listserv on the morning of  the PIT Count. There will be one version for the unsheltered count, one for emergency shelter/GA motel count, and one for transitional housing count.

The paper form can be filled out if you are surveying people in locations that do not have wifi/data or for other circumstances in which you are unable to use the electronic form. On the website, you will also find a Microsoft Word version of the paper form.

Feel free to reach out to Laurel Chen or your local Point in Time Count coordinator with questions.

The mission of the Coalition is to end homelessness in Vermont through sharing information, developing resources, providing a forum for decision-making and to promote decent, safe, fair, affordable shelter for all.