The Elizabeth House Pre-Screening

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

    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
    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.
    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.
    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.
    Copyright Care Net Pregnancy Center of Dane County | All rights reserved
    Sitemap | Privacy Notice

    Donate