Client Referral Form

The purpose of the Strides Outreach Program is to meet the needs of unsheltered people where they are.

In a greater effort to move people off the streets, reduce encounters with law enforcement and to generally prevent living unsafely outdoors, we empower the community to be part of the solution by referring to the Strides Outreach Program.

Please complete the following form to let us know about a potential Client for the Strides Shelter. If you prefer to complete a paper form, please download the form, provide as much information about the potential client as you are able, and return the completed form to Charlene Murray.

Your Name(Required)

First Last

Your Email Address(Required)

Your Phone Number(Required)

Contact Information for the Client(Required)

Please provide any contact information you have for the Client

Engagement Dates with the Client(Required)

Please indicate the date(s) you made contact with the potential Client

Engagement Location(s)(Required)

Please indicate where you made contact with the potential Client

Physical Description of the Client(Required)

Please provide a physical description of the Client. Include any identifying features, such as hair style/color; jacket/clothing color; approximate height/weight; and anything else that stands out.

Client Photo

If possible, please upload a photo of the Client so that we may easily locate them.

Accepted file types: jpg, png, Max. file size: 2 MB.

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