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Three adults and a toddler smiling, holding a large blue house-shaped frame that says #WeMadeHomeTheGoal inside a cozy room.

Housing Counseling or Financial Coaching Intake Form

Take the first step toward your financial goals.
Whether you’re looking to buy a home, improve your credit, create a budget, manage debt, or explore your housing options, Lacasa’s counselors are here to help. Complete the form below, and a member of our team will contact you to learn more about your goals and discuss the next steps.

Housing Counseling or Financial Coaching Intake

Counseling Session Type


Indicate your preferred language below if you are unable to communicate in English.


Please tell us why you would like to work 1-1 with a counselor or coach and what steps you have taken to prepare yourself already. 


Contact Information











Housing Information






Personal Information







Income and Savings

Please answer the following questions using gross income (before taxes).





Additional Income







Credit Score



Debt Information

My Monthly Debts are:
Include minimum payments only





Pay Stubs





Availability

You will need at least 1-hour available to schedule your appointment.


Acknowledgements


I understand that a Housing Counselor or Financial Coach will work with me to address the areas that I've chosen free of charge. I commit to attending appointments scheduled and completing items that I agree to put on my action plan within the agreed upon timeline. If I fail to do these things, I understand that my Counselor or Coach has the right to discontinue services so that they can focus on other people who need help.

Link for Privacy Policy and Program Disclosure are found here: https://lacasainc.net/fec-privacy-and-program-disclosure/

I/We hereby certify that the above information is true and complete to the best of my/our knowledge. Lacasa is a HUD approved agency and member of NeighborWorks America Network. It is extremely important for us to track the number of class participants that purchase a property. The information we collect allows us to report the impact that our services have in our community as well as to fulfill grant requirements. Data collected in this intake is for informational purposes ONLY. Lacasa does not send marketing or publicity material of any kind. 


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