The Sophia Way | Intake and Pre-Screen Form
Assisting women from homelessness to stable independent living.
homeless women, homeless, homelessness, shelter, safety, stability, shelter, women's shelter, Bellevue, homeless in King County
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Intake and Pre-Screen Form

Please fill in the Intake and Pre-Screen Form for our 21-bed Night Shelter Program.

After you give The Sophia Way the authorization to conduct a background check, we will run the check and contact you if we need any further clarification. Upon approval, you will be placed on our wait list. When a bed becomes available, we will contact you in the order that your name appears on our wait list.

For more details, click here

Eligibility Criteria for Sophia’s Place

You must provide identification and/or photo id for emergency purposes only (all information will be kept confidential) and give The Sophia Way the authorization to conduct background check.

  • Abide by the Program Contract
  • 11:00 PM curfew
  • No drinking
  • No using
  • Submit to Breathalyzer
  • Allowed to bring only 7-10 outfits.
  • Do all chores.
  • Allow random cubicle and locker checks.
  • Mandatory weekly meeting with our case manager
Sophia's Place - door a

Contact Information

Name (required)

Date of Birth (required)

Phone Number - primary (required; format xxx-xxx-xxxx)

Phone Number - secondary (required; ; format xxx-xxx-xxxx)

Email (required)

Demographics

Homeless?
yesno

City you became homeless from

Current City of Residence

Minor Children?
yesno

Childen in Custody?
yesno

Currently in a domestic violence situation?
yesno

Currently in a substance abuse situation?
yesno

Have you ever been arrested?
yesno

If yes, what was the charge?

Former Sophia's Place resident?
yesno

If yes, how many times?
123 or more