Skip to content

Back arrow to return to all resources page All resources Domestic Violence Housing Preference

  • Housing
  • Form
  • Letter

Survivors of domestic violence often do not have a safe and stable alternative living arrangement available. With this resource, the hope is that the survivor can secure subsidized housing that is safe for them and, if relevant, their dependents.

This resource can be used to advocate for a patient who has experienced domestic violence, dating violence, sexual assault, or stalking and who currently lives in or is applying for HUD-subsidized housing. Under the Violence Against Women (VAWA) act, there are two important provisions that protect tenants living in subsidized housing:

1). HUD-5382: Allows a survivor of domestic violence, dating violence, sexual assault, or stalking to seek VAWA protections from housing provider (i.e. preventing eviction) by providing a written request that documents the incident(s) of interpersonal violence.
2). HUD-5383: Allows a survivor of domestic violence, dating violence, sexual assault, or stalking to request an emergency transfer of housing.
One or both of these forms should be filled out by or on behalf of the patient who is requesting assistance. In addition, a letter from a medical provider outlining the impacts of interpersonal violence on the patient’s physical or mental health can substantially help an applicant’s case.
Additional Information: For more information about services for survivors of domestic violence in RI, including shelters, advocacy resources, and immigration support, visit the website of The RI Coalition Against Domestic Violence. The 24/7 hotline can provide assistance and referrals to survivors and providers at 1-800-494-8100.

Documents

  1. Medical Provider Letter Template
    Download Letter Template
  2. [For Lifespan Providers] Letter Template with Lifespan Letterhead
    Download Letter Template
  3. Form HUD-5382 (To be filled out by or on behalf of the patient)
    Download Form
  4. Form HUD-5383 (To be filled out by or on behalf of the patient)
    Download Form

Next steps

The patient should take the completed form and medical provider letter to the various housing authorities where they are applying for subsidized housing. It is helpful to make multiple copies of the letter for the patient.