Due to the current Canada Post strike, donors are encouraged to use our online form, call or visit us in person to make a year end gift.
DONATE HERE

NEED HELP? Call the Hôtel-Dieu Grace Healthcare 24 Hour Crisis Line at 519-973-4435
If you’re thinking about suicide, 9-8-8 is here to help. Call or text 9-8-8 toll-free, anytime.

CMHA Windsor-Essex County

SearchClose

CMHA Windsor-Essex County

Find CMHA in your area
Find CMHA in your area
Menu Close
Search

What are you looking for?

You are currently on the:

CMHA National

Visit our provincial websites

Environmental Safety Self-Assessment

Environmental Safety Self-Assessment Form for Discharged Clients

FAILURE TO REPORT ON THE HIGHLIGHTED MANDATORY COMPONENTS LISTED ON THIS FORM WILL RESULT IN TERMINATION OF THE RENTAL SUBSIDY WITH NO ABILITY TO REINSTATE IT.

Smoke Detector / CO Detector (if installed):(Required)
*If you do not have a working smoke detector, contact your landlord immediately and report.
Clear route of pathways throughout unit:(Required)
Safe electrical practices in use:(Required)
Fire evacuation plan in place:(Required)
Any pest issues (Bedbugs/Cockroaches):(Required)
*Any pest issues, contact your landlord immediately and report.
Current Tenant/Rental Insurance(Required)
MUST SIGN AND DATE. FAILURE TO REPORT MAY RESULT IN TERMINATION OF THE RENTAL SUBSIDY WITH NO ABILITY TO REINSTATE IT.
Skip to content