Haven Legacy Living

Move-In Readiness Form

Join our free future move-in interest list. Share when you are ready to move and receive updates as housing becomes available. Placement depends on eligibility and availability.

Fields marked * are required. Your answers are submitted to Haven Legacy Living’s private inbox. Call (470) 969-5900 for help.

Your information

Full name *

Phone number *

Email address

Preferred county or city *

Date you will be ready to move

Room preference *

Monthly housing budget ($)

When will you be ready? *

Referral information (if applicable)

Referring agency and case manager

Case manager phone or email

Permission to contact

I give Haven Legacy Living permission to contact me about my move-in readiness and future availability. If I am submitting for someone else, they have agreed to be contacted. *

By submitting, you send these answers to Haven Legacy Living for review and follow-up. No payment is collected here. Please do not include Social Security numbers, bank account information, or medical records.

Keep this page open until you receive confirmation.

View the printable PDF version