Partners in Housing

Program Application

You may download the application in either Word or PDF format.  For an application to be complete, you must also complete the Address & Employment History, which can also be downloaded below.   Please fill out both forms completely and hand deliver or mail the forms to 455 Gold Pass Heights, Colorado Springs, CO 80906. 

We are located on the Myron Stratton Home campus on the far south end of S. Nevada Ave.
Click here to go to our location/map page.  Please call (719) 473-8890 with any questions.

Applications

Application (Word)

Application (PDF)

Application (Word Espanol)

Application (PDF Espanol)

Peak Region Comprehensive Client Management System Privacy Notice

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

PLEASE READ THIS CAREFULLY:
Effective Date: 30 June 2006
Our Duty to Safeguard Your Protected Information                                                

Partners In Housing will collect information about you and your family to provide you services. This information will be entered into the Pikes Peak Region Comprehensive Client Management System (CMS) which is our data collection system.

We are required to protect the privacy of your identifying information.  We must give you notice about how, when, and why we may use or disclose any information you share with us.  We are also required to follow the privacy practices described in this Notice, although Partners In Housing reserves the right to change our privacy practices and the terms of this Notice at any time.  You may request a copy of this notice from any participating CMS Agency.

How We May Use and Disclose Your Information
Data collected is used and disclosed for reporting on health and human service needs in our community.  Personal information that could be used to tell who you are will never be used for these reports.  We will not turn your information over to a national database.  We must have your consent to use or disclose your information beyond these purposes unless the law permits or requires us to make the use or disclosure without your permission.

Your Rights Regarding Your Information

• You have the right to ask for information about who has seen your information.
• You have the right to see your information and change it if it isn’t correct.
•  You have the right to change your release authorization regarding the use of your data.