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 our help filling out the forms, call CareOregon HRSN Customer Service at 971-236-2998.
If you are filling out the PDF forms, send your completed request form and budget worksheet to CareOregon HRSN Customer Service by one of the following:
- Fax (preferred): 503-416-1376
- Email: hrsncx@careoregon.org (please call 971-236-2998 after you send your email)
Documents related to your request should be uploaded with your request form. You can submit your documents in one of these ways:
- Fax (preferred): 503-416-1376
- Attach them to your request form when you submit it
- Upload them through the member portal (you can upload documents, but you cannot start a new request there)
- Email: hrsncx@careoregon.org (please call 971-236-2998 after you send your email)
Uploading documents using the member portal
- 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.
