The Elizabeth House Pre-Screening

The Elizabeth House offers safe and stable housing to pregnant homeless single women, ages of 18+. We accept first time pregnant women, women who have just given birth and expectant mothers with a child up to the age of two.

Please call or email for more information.  608-259-1605

Interested in becoming part of The Elizabeth House? Take the first step by completing this form. We will respond to you within 2 to 3 business days.

Your name (required):
Your phone (required):
Your email (required):
Your age (required):
Are you homeless or in unstable housing? YesNo
Are you pregnant? YesNo
If so, how far along are you?
Do you have an additional child(ren)? YesNo
If yes, what are their ages?
If yes, are they currently in your care?YesNo
Do you have alcohol or drug concerns? YesNo
If so, have you been sober for at least 6 months? YesNoN/A
Do you have a criminal background?
YesNo
Do you have any diagnosed mental health conditions or concerns about your mental health? YesNo
How did you hear about The Elizabeth House?

Need Help Filling Out This Form? Click to Email Us.

Is The Elizabeth House Right for Me?

Are you pregnant?
The Elizabeth House is for women who are pregnant or who have an infant.
Are you a first time mom?
The Elizabeth House is mainly for pregnant women who do not have other children in their care or who have only one other child who is under the age of two. Exceptions are made on a case by case basis.
Do you have children over the age of two?
The Elizabeth House is not able to accommodate children over the age of two. If your older children are in your care, please contact us for a referral to another agency.
Do you have alcohol or drug concerns?
Before becoming a resident of The Elizabeth House, you must pass a urine drug test.
Do you have a criminal background?
The Elizabeth House provides a safe environment for our residents. To provide a safe environment, we are not able to accept women who have a violent criminal history. We are also unable to accept any woman who has had a child removed from her care.
Do you have a diagnosed mental health condition?
The Elizabeth House is not equipped to care for women who have been clinically diagnosed by their doctor with schizophrenia, severe bi-polar or severe behavior disorders.
Are you ready to make a change in your life?
If your life is not going how you'd like, and you're ready to make some changes, The Elizabeth House could be for you. We specialize in giving pregnant women a safe, nurturing place to make a new start. Complete the screening form today to get started.

The Elizabeth House is a program of Care Net Pregnancy Center of Dane County.
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