Comprehensive Referral & Intake

Process

What to Expect

Our intake process is straightforward. Here's what happens after you apply.

Complete the intake form below with your information.

Our team reviews your application within 48 hours.

Provide any required documents and complete intake paperwork.

Once approved, your move-in ready room awaits.

Intake Form

Complete all required fields (*) below. We'll review your application and respond within 48 hours.

Client Information

Full Name *

Date of Birth *

Phone *

Current Address *

Supervision Status

Current Supervision *

ProbationParolePretrialNone

Referring Agency

Officer Contact

Employment / Income

Employer *

Position

Monthly Income *

Work Schedule

Housing Details

Desired Move-In Date *

Emergency Contact *

House Rules Acknowledgment

By checking the box below, you acknowledge and agree to the following house rules:

I have read, understand, and agree to abide by all house rules and policies of Blu Manor. *

Signature

Full Legal Name *

Date

March 10, 2026

By submitting this form, you consent to Blu Manor contacting you regarding your housing application. For immediate assistance, call 727-563-6540.