APPLY TO THE BURFOOT HOUSE: Program for Homeless Single Women
 
We welcome your application to the Burfoot House. The following links (red lettered items below) includes materials you will need to apply to the Burfoot House. Please note that the Client Handbook will provide you with a good overview of the program tailored to your personal growth and employment needs, as well as, requirements of the house to ensure peace while at the Burfoot House. All of our clients work, save, attend classes on-site, attend church of their choice, and have the opportunity to develop self-sufficiency. 
 
Firstly, complete forms 1 and 2 and be sure to press the submit button. Based on the information you share, we will determine your eligibility and quickly submit a background check. Next, you must call CIBH - Chesapeake Integrated Behavioral Health between 7:30 am - 1:00 pm and have them complete the attached CIBH form (print and take with you). 
CIBH telephone number: 757.547.9334 (call today) 
CIBH Location: 224 Great Bridge Blvd, Chesapeake, VA 23320

Items you need to bring with you to the appointment:
* Photo ID
* Social security card
* Insurance information (IF you have insurance, bring the co-pay amount)
* Income verification pay stub or state no income
* You will be required to pay$5 if no income

Call Lisa Dixon, Executive Director of the Burfoot House, after your appointment tomorrow at 757.904.9758 cell phone.
 

New Client Intake Form
Medical Screen Form
Mental Health Screen Form
Personal Information Form
Client Handbook