D.10 REQUEST FOR EXTENSION.pdf

This is a VA CRS (Contracted Emergency Residential Services) Extension Request Form used to request extensions for veteran housing services. The form must be submitted to the VA CERS Liaison 7 days before the end of a previous referral or when requested by the CERS Liaison.

The form captures essential information including the veteran's details, bed days utilized, contract case manager information, housing goals and progress toward those goals, projected discharge date, referrals, and justification for the extension request. The bottom portion is reserved for COR (Contracting Officer's Representative) use only, where they can indicate approval or denial, processing date, and add comments. The form requires a signature from the Contract Case Manager and is associated with a larger contract opportunity for Healthcare for Homeless Veterans services at the Kansas City VA Medical Center.