DETROIT CoC HMIS USER LICENSE
UPGRADE REQUEST FORM
Please complete the form below and attach to your HelpDesk Request www.handetroit.org/hmis

Agency Name: Click & enter text.

Project: Click & enter text.

Name of Person Making Request: Click & enter text.

Phone No: Click & enter text. Type: Click & Choose.

Date of Request: Click and choose a date.

End User Name: Click & enter text. End User Title: Click & enter text.

End User’s Email Address: Click & text.

UPGRADE USER’S ACCESS LEVEL: (Click box to select)

☐ Region 10 Read Only

If you are requesting an upgrade to your existing HMIS license, please answer the following questions:

How long have you been entering data on HMIS? Click & enter text.

Why does your role necessitate an upgrade in your end user license level? Click & enter text.

How long will you require an upgraded license? Click & enter text.

Does End User need access to ART Reporting? Click & Choose.

List additional projects this End User will require access to: Click & enter text.

All new end users are required to complete the trainings listed below; which can be found at www.mihomeless.com. Please attached corresponding certificates when submitting this request.