Referral Form for Housing Assistance for Ukrainian Clients

The purpose of this form is to recommend Ukrainian clients for housing assistance. The client must meet the following criteria:

  • Citizen or national of Ukraine and has received humanitarian parole
  • Arrived in the United States between 2/24/22-9/30/23, and lives in Oregon
  • Has documentation to show their legal status and date of entry in the United States
  • Does not have a Uniting for Ukraine sponsor, or their sponsor is unable to provide support

Refugee Care Collective may have up to 2-3 months of housing to provide, dependent on eligibility and demonstrated need.

  • Please fill out this form to the best of your ability. We will not contact potential clients without contacting you first.

If you are having trouble viewing the form below, please try a different browser or email to complete the referral.

If you have not heard back within 48 hours, please email directly.


"*" indicates required fields

Please only include the full name for the head of household.
Is the client a citizen or national of Ukraine?*
Did the client receive humanitarian parole?*
If you only have the month and year, that is acceptable at this time.
Please share as much information as you are able to about the individual or family's current housing situation, along with why this client needs housing assistance support.
Please write "Seeking housing" if a home hasn't been found yet.
Has this client already received housing assistance support through Oregon Department of Human Services?*
Please share to the best of your ability. Ex: Hassan Male 39, Amina Female 37, Fatima Female 4
Priority Level:*
Please share as much information as you are able to about the individual or family.

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