Sprott House Application - Service Provider Referral Form (New) Logo

  • Sprott House Application - Service Provider Referral Form

  • Things to remember when referring folks to the program

    1. Applications will be considered for this application period ONLY. If an applicant is not successful during this period, they will need to reapply again once there is another spot available as we do not keep a waitlist.
    2. The YMCA Sprott House program is a one-year program with the possibility for extensions to up to two years (determined by need and case management goals).
    3. Please designate on the application form if the client has a preferred method of contact. We will default to their email address unless otherwise specified.
    4. If you are a service provider completing a referral, we ask that you complete the Service Provider Referral Form to give us a clearer picture of the client you are referring.
    5. Please also complete the attached Release of Information form so we can communicate with you!
    6. If you have a service provider, please also complete the attached Release of Information form so we can communicate with them.

    Notes On Eligibility

    1. The YMCA Sprott House program prioritizes applicants who identify within the 2SLGBT2+ community. We also further prioritize folks who both identify within the community AND who are currently experiencing situations that compromise their safety.
    2. As a transitional housing program, there is an expectation that participants are on track for being ready for independent living AND able to provide for themselves, including completing their own cooking, grocery shopping and cleaning. This does require folks to have a source of income. Please keep this in mind when referring individuals to the program.

    Other Expectations

    1. Meet regularly with case managers to complete goal setting and follow up on goal setting.
    2. Buy and cook their own food.
    3. Play their part to maintain common spaces, including kitchens and lounge.
    4. Maintain personal hygiene and laundry and the general health & safety of their own room.
    5. Wake up for school/work/appointments (we provide short term support for this though in the form of wake ups.)
    6. Maintain appropriate behaviour/boundaries in the house and follow program guidelines for respect and anti-racist/anti-oppressive/gender-affirming behaviour.
    7. Schedule and commit to attending their appointments.
    8. Participate in house programming where possible.
    9. Some folks attend external programming, some folks attend school/work, but it is an expectation that folks will be active and not stay home all the time.
    10. Participate and contribute to shared living with the other 24 participants who are part of the Sprott community.
    11. Manage positive personal relationships within the house.

    Our Services

    1. 24 hour staff support (Note: staff are not mental health specialists, but can refer to those who are.)
    2. Case Management (required for all participants.)
    3. Connections to external resources and service providers.
    4. Housing support when required.
    5. Informal Counselling/Support.
    6. Crisis intervention.
    7. Employment counselling and supports, and Harm Reduction counselling/groups through YMCA services.
    8. Assistance with much of the above on a short term basis (i.e. helping folks schedule appointments, problem-solve behaviours/relationships, short term wake-ups, attend a few appointments at first, teach life skills like cooking and laundry, etc.)
    9. Assistance with budgeting and offer a Financial Literacy program several times/year.
    10. House Programming (art therapy, financial literacy, BIPOC group, Trans/Nonbinary group, Sunday dinner, peer-led workshops and more.)

  • Referring Worker Information

  • Section 1 - Relationship Between Referring Worker and Applicant

  • Section 2 - Life Skills Observations

  • On a scale of 1 (poor) to 10 (excellent), please rank the applicant on the following life skills as it relates to their current situation.

  • Section 3 - Barriers and Challenges

  • The following questions are intended to give us more information about some potential barriers or challenges faced by the applicant. Answering yes to these questions will not necessarily hinder the applicant’s chances of being accepted into the program; however, significant challenges may indicate a higher need for 1:1 support than our program is designed to provide. We ask that you include observations about the applicant’s willingness and ability to make changes, seek supports and move forward through these challenges.

    Please identify any of the following areas that you believe may require support.

  • Section 4 – Need for Support

  • Referring Worker’s Agreement Statement

  • Please note that after clicking the Submit button, below, you will be redirected to the online Consent Release Form.

  • Should be Empty: