Get Help — Lowcountry Continuum of Care

Check this box if you are interested in getting on the shelter list

Check this box if your name is on the shelter list, and you are checking in

Birth date

In what county are you in?

Phone Number

Can this number receive text notifications?

I do not have a phone

Email Address

I do not have an email address

If you don't have a phone or email, what is a good time and place where outreach staff could meet with you? (ex: Wednesdays 12pm Neighborhood House)

Number of adults in the household

Please list the name(s) of all other people 18 or older in the household. All adults 18 and over must also complete an online form.

Number of children in household

Current housing situation: *

Staying on the streets (car, outdoor location)

Staying with friends/family

Staying in a hotel

Fleeing or attempting to flee domestic violence

At-risk of homelessness (going to be evicted/lose housing)

How long have you been staying there?

One night or less

Two to six nights

One week or more but less than a month

One month or more, but less than 90 days

90 days or more, but less than a year

One year or longer

Provide us with any other details about your current situation that you think we should know

I agree for my information to be entered into a database for housing and shelter referrals.

For providers only

Charity Tracker ID:

If you are a provider assisting in completing the online form, please include your name, agency and e-mail.

If you are currently experiencing homelessness: