Download PDF Forms

Application Forms

If you are considering applying for the MHCHS’s Community Housing program, you are required to complete an Application Form. Application forms should be dropped off at the Medicine Hat Community Housing Society Social Housing office at:

516 3rd Street SE, #104
Medicine Hat, AB
T1A 0H3

Standard Application

This form is for individuals and families applying for one of the following social housing programs:

  • Community Housing (Family or Special Needs)
  • Affordable Housing
  • Private Market Rent Supplements

Seniors Application

This form is for adult individuals applying for the following social housing program:

  • Seniors Self Contained Housing

Application Update

All approved applicants are served according to level of need, so it is important to notify the MHCHS administration of any changes in your circumstances if you are on a waitlist for one of our social housing programs. Complete the Application Update form below to submit your changes to the MHCHS administration as soon as possible.

Other Forms

Rent Report

Rent Adjustment Form

If you require a rent adjustment due to a loss of income, it is your responsibility to report this change to ensure you do not pay more than 30% of your income towards your monthly rental fees. Fill out this form to report a change in income to the MHCHS and ask for a rent adjustment. Please note: rent adjustments cannot be requested by households participating in the Affordable Housing or Private Market Rent Supplement programs.

Transfer Request Form

If you believe that your current housing program no longer suits your needs, you may request a transfer to another rental unit or housing program by filling out this form. Please consult with your program coordinator to determine if you qualify for a housing program transfer.

Rent Payment Permission Form

The MHCHS can only accept rental payments from the leaseholder. If you require a third party to pay your household rent on a regular basis, permission is required and you must fill out this form.

Maintenance Request

All tenants are responsible for reporting damage and/or regular wear and tear in their unit. If you would like to submit a maintenance request please contact the MHCHS Administration office.

Please note: all maintenance emergencies (i.e. fire, flood, no water and/or no heat, etc.) must be reported immediately. Please call the Administration office at 403.527.4507 and press 3 for maintenance emergencies.

Moving Out

If a tenant intends to move, they are required to inform the MHCHS 30 days prior to their move by filling out the Notice to Vacate form. This form should be faxed to the MHCHS Administration Office or delivered in person, no later than 30 days prior to the move out date. Tenants who are moving out of a MHCHS unit are required to complete all tasks on the comprehensive cleaning list provided, to ensure a full refund for their security deposit.

Download PDF Forms

Copyright (c) 2015 Medicine Hat Community Housing Society
Central Office
#104, 516 - 3rd Street SE Medicine Hat, AB T1A 0H3
Homeless & Housing Development Department 403.528.5183