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Full Name *

Phone Number *

Email Address *

Do you currently have a VASH Voucher? *

How many bedrooms does your voucher support? *

Have you located a home for SALE or VACATE you are interested in? (select) Yes or No If YES provide the address, city , state a zip---and allow box same as other page for them to enter info *

Do you require any special amenities needed in the home for a disability? (select all that apply)

None
Ramps and Accessible Entrances: Ensure that all entrances to the home are accessible with ramps or lifts.
Wider Doorways and Hallways: To accommodate wheelchairs and mobility devices, doorways and hallways should be widened.
Grab Bars and Handrails: Install grab bars and handrails in bathrooms, hallways, and other areas for added support and safety.
Roll-In Showers and Accessible Bathtubs: Bathrooms should have roll-in showers or accessible bathtubs with seating and hand-held showerheads.
Lowered Countertops and Cabinets: Kitchen and bathroom countertops and cabinets should be lowered for easy access.
Non-Slip Flooring: Use non-slip flooring materials to prevent falls and provide better traction.
Adjustable Shelving and Closets: Shelving and closets should be adjustable to different heights for easy reach.
Lever-Style Door Handles and Faucets: Replace traditional knobs with lever-style handles for easier use.
Stair Lifts or Elevators: Install stair lifts or elevators for multi-story homes to ensure accessibility to all levels.
Smart Home Technology: Utilize smart home technology for lighting, temperature control, and security systems that can be operated remotely or with voice commands.
Accessible Light Switches and Outlets: Place light switches and electrical outlets at accessible heights.
Emergency Alert Systems: Install emergency alert systems that can be easily activated in case of an emergency.

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