Apply for temporary housing

Free lodging for patients and families receiving medical care in Abilene. It takes about ten minutes.

01

Submit the application

Complete the form below. Fields marked with a red asterisk are required — including an emergency contact.

02

We'll contact you

Our office reviews every application and calls to confirm a house is available for your dates. Urgent? Call 325-673-4673 or text 325-352-7594.

03

Hospital or church referring?

Social workers, chaplains, case managers and pastors are welcome to call our office directly or complete the form on the guest's behalf.

Houses for Healing Guest Application

This application is not a guarantee of occupancy. Please read our privacy statement before you begin.

Houses for Healing Privacy Statement

Houses for Healing ("H4H," "we," or "our") is a Christian nonprofit ministry that provides free lodging to individuals and families experiencing medical crises. We respect the privacy of every guest, donor, volunteer and partner, and we want you to feel confident that your personal information is handled with care. Although H4H is not a medical provider and is not covered by HIPAA, we voluntarily follow HIPAA-aligned privacy practices to protect personal information.

What information we collect. To provide lodging and communicate with guests, we may collect: name, address, phone number or email, emergency contact, general purpose of stay (non-medical description), dates of stay, and referral source (hospital, chaplain, caseworker, etc.). We do not collect medical records, diagnoses, treatment information or insurance details — please don't include them on this form.

How we use your information. We use personal information only to assign houses and manage your stay; communicate with you during and after your visit; track program usage and improve our ministry; and share de-identified data with universities for research (optional and anonymous).

We never sell personal information, use it for marketing, or share it with unrelated organizations.

Applicant — the person filling out this form

I am… *

Full name *

Email *

Phone *

Street address *

City *

State / province *

ZIP / postal code *

County *

Country *

Guest — the patient who will stay with us

The guest is the same person as the applicant (fills in name, email, phone and address)

Guest full name *

Guest date of birth

Guest email *

Guest phone *

Street address *

City *

State / province *

ZIP / postal code *

County *

Country *

Is the guest a veteran? *

YesNo

Treatment facility (e.g. Hendrick North, Hendrick South, Texas Oncology, West Texas Rehab) *

Date housing is needed *

How long will the house be needed? *

Total number of people staying *

Will a caregiver stay with the guest? *

YesNo

Caregiver — the person staying with and caring for the guest

The caregiver is the same person as the applicant (fills in name, email, phone and address)

Caregiver full name *

Relationship to the guest *

Caregiver email *

Caregiver phone *

Street address *

City *

State / province *

ZIP / postal code *

County *

Country *

Emergency Contact (required to qualify)

Name (family member or friend) *

Relationship *

Phone *

Address, city, state, ZIP

Name of relative nearest to the treatment facility

Relative’s city / state / ZIP

Relative’s phone

Ministry Need

Reference & Referral

Reference — name, address, phone

Who referred you? (hospital, chaplain, social worker, church…)

Social Work Intern Services – Voluntary Participation

Houses for Healing partners with social work interns to provide additional support, resources, and assistance to guests. Participation in these services is completely voluntary and will not affect your eligibility for housing or other services provided by Houses for Healing.

Please select one: *

I OPT IN – I agree to be contacted by a social work intern regarding available support and services.I OPT OUT – I do not wish to participate in social work intern services at this time.

I understand that I may change my decision at any time by notifying Houses for Healing staff.

Agreement

I have read the Houses for Healing Privacy Statement above. *

I authorize the verification of the information provided on this form for the processing of this application. I understand that this application is not a guarantee of occupancy. *

Type your full name as your signature *

Date *

Fields marked * are required.

Prefer paper? Download the printable application (PDF) and fax it to (325) 238-9320 or mail it to PO Box 2320, Abilene, TX 79604.
Physical address: 3065 Hickory St., Abilene, TX 79601.