This form is for updating directory information on grantees of the federal Health Care for the Homeless Program and their subcontractors. This program is also known as Section 330(h) of the Public Health Service Act. Current grantees descriptions are available here . Please review the current description of your project, enter only onto this form corrections for any data that is out-of-date or otherwise incorrect, and press the submit button. The corrected data will be made publicly available as the 2009-2010 HCH Grantee Profiles on this website.


Fields marked with * are required

Does Your Entry Need Correcting? *	No, it is complete, current and accurate. (Fill in Required fields below & click “submit”.) Yes, please make the corrections indicated below. (Fill in new information where appropriate and click “submit”.)
Individual Submitting Form: *
Submitter's Telephone *
Submitter's Email *
Grantee Organization Name *
Mailing Address
City *
State *
Zip *
Fax
Web Site
Director or Executive Officer *
Phone
Email
Medical Director
Phone
Email
HCH Coordinator
Phone
Email
UDS Number
Estimated number of homeless people in this city on an annual basis
Number of homeless clients served annually by grantee and subcontractors
Comments or questions about this updating process
Subcontractors or Sub-recipients
HCH Clinic/Project Name (if different from grantee name)
HCH Clinic/Project street address (if different)
HCH Clinic/Project City (if different)
NHCH Clinic/Project State(if different)
NHCH Clinic/Project Zip(if different)
Clinic/Project telephone
Clinic/Project fax
Clinic/Project e-mail
Clinic/Project Website
Brief Introduction
Services
Linkages

Does Your Entry Need Correcting? *
Individual Submitting Form: *
Submitter's Telephone *
Submitter's Email *
Grantee Organization Name *
Mailing Address
City *
State *
Zip *
Fax
Web Site
Director or Executive Officer *
Phone
Email
Medical Director
Phone
Email
HCH Coordinator
Phone
Email
UDS Number
Estimated number of homeless people in this city on an annual basis
Number of homeless clients served annually by grantee and subcontractors
Comments or questions about this updating process
Subcontractors or Sub-recipients
HCH Clinic/Project Name (if different from grantee name)
HCH Clinic/Project street address (if different)
HCH Clinic/Project City (if different)
NHCH Clinic/Project State(if different)
NHCH Clinic/Project Zip(if different)
Clinic/Project telephone
Clinic/Project fax
Clinic/Project e-mail
Clinic/Project Website
Brief Introduction
Services
Linkages