In order to be eligible for the VAH program, you must be:

  • A single male Veteran within our service area (Northern California)
  • A Veteran of any era
  • Willing to engage in weekly case management
  • Willing to live in communal housing
  • Assessed as not meeting criteria for acute psychiatric or medical care
 
Please note that program eligibility is determined on a case by case basis. Meeting criteria for program eligibility does not guarantee a Veteran will be admitted to the program.

Step 1

Please print, sign & return the Department of Veterans Affairs Health Release Form

DOWNLOAD THE FORM

Completed forms can be:

  • Emailed to admin@vahouse.org
  • Faxed to 925.822.3185
  • Mailed to 1820 Galindo Street Suite 210, Concord, CA 94520

PICTURE VERSION FOR DOWNLOAD

step 2

Submit the below web application to us:

    Name:

    Date of Birth:

    Phone Number:

    Email Address:

    City / State of Residence: (Please note: We are located in and serve Northern California):

    Gender Identity:

    Military Branch of Service:

    Date: a. Entered: b. Exit:

    Type of Discharge:

    Any Service Connected Disabilities?:

    Source of Income:

    Last Four of SSN:

    Form of Medical Coverage:

    Are you receiving any medical treatment or experiencing any medical issues?:

    Understanding the mission and goals of the Veterans Accession House (VAH), explain why you are interested in VAH, instead of another traditional transitional housing program?:

    What do you hope to accomplish during your stay? What, where, when, how and why? Explain:

    Are you currently employed? Please explain your employment situation:

    Please explain your education and any special skills:

    Are you receiving or in need of any supportive medical/ counseling services?: