The Homeless Services Center is dedicated to the coordinated provision of services for homeless persons.
The goal of the Homeless Services Center is to provide both emergency and transitional services to
homeless individuals and families that will enable our clients to achieve self-sufficiency.
Paul Lee Loft Referral Form
Date ___/___/___
Referring Agency’s Information
Agency Name__________________________
Referred to
Paul Lee Loft
Case Manager’s Name____________________
PLL Assistant Manager
Address_______________________________
115D Coral Street
City, State_____________________________
Santa Cruz CA, 95060
Phone_________________________________
Phone (831) 458-6020
Fax____________________________________
Fax
(831) 316-5010
Email__________________________________
Client Information
First Name__________________________ Last Name________________________________
Mailing Address________________________________________________________________
Phone Number_________________________________________________________________
Best Days/Times to reach the client_________________________________________________
Eligibility requirements
 Clients must be receiving active case management.
 Clients must be enrolled in one of the following Housing Programs (Please choose one)
Disabled and Medically Vulnerable Section 8 Preference (DMV):
HSC
SCAP
HPHP
 County Mental Health
Other _____________________________
MATCH
 Shelter + Care
SSVF
HUD-VASH  CHAMP Housing
Treatment SLE Work (with a VI-SPDAT score <5)  Housing
 Section 8
HUD Bonus Project
Older Adult Team
Homeward Bound