How do I request housing support?
If you have met the eligibility standards listed above and want to request a housing support, simply click the button below to fill out the online housing request form. Jackson Care Connect will review your application to determine whether your request meets eligibility criteria for Health Related Social Needs (HRSN) or Flexible Services based upon the information you provide. Successful submission of a request does not mean it will be approved.
Digital Housing request formIf you prefer, you can download and fill out the Housing Request Form (PDF) instead.
Also, you will need to download and fill out the Health Related Income/Budget Worksheet and submit it with your request.
You can fill out either form yourself, or with the help of a parent, a caregiver, or a guardian/support/trusted friend, or a staff member from an organization or clinic.
If you have questions or would like help filling out the forms, call CareOregon Customer Service at 503-416-4100. Press option 1 for “member,” then option 6 for “social needs.”
Send your request form to CareOregon Customer Service by one of the following:
- Email: hrsncx@careoregon.org
- Fax: 503-416-1376
- Member portal
Documents related to your request should be uploaded in advance. They can be emailed to hrsncx@careoregon.org or uploaded to the member portal. If you already have an account go here to login or you can find registration information here to set up an account. Once logged in, upload your documents by doing the following:
- Go to the message center and click "new message"
- Click "add recipients" and select "Health Related Services Requests"
- Add HRSN in the subject line and attach the file(s) to the message using the attach file feature
- Add any other context and click "send"
Additional resources
Here are some community resources for members who need urgent help to prevent eviction or who have already become homeless:
- For the most up-to-date housing resources in your area…
- Visit www.211info.org
- Call 2-1-1 (or 1-866-698-6155)
- Email help@211info.org
- Text your zip code to 898211 (TXT211) Monday – Friday, from 9 a.m. to 5 p.m .
- Community Alliance of Tenants has a comprehensive resource page for Oregon renters.
- For help with utilities, members can also contact their local Community Action Agency.
