Sign Up for Home Repairs

Home Repair Intake Form

If you are interested in HDA’s Home Repair Program, please complete the form below.
Once submitted, a representative from our office will contact you to get further information and will send you a checklist of information needed by postal mail. Upon receiving HDA’s Client Checklist, you’ll then need to gather all documentation requested and either mail it back to our office or bring it with you to a scheduled in-person meeting with our Home Repair staff. Once the documents have been received, we will begin to check your eligibility and will update you on your status as soon as possible.

Step 1 of 5 - Personal Information