CARES Resource Navigation Request (Andre)

English – I would like to complete the evaluation in EnglishEspañol – Quiero completar la evaluación en Español

CARES (Resource Navigation)Request
CARES resource navigation provides one-on-one support to help you:
- Identify your goals
- Explore available resources
- Develop a clear action plan
- Receive follow-up support
This isn’t just a list of resources—it empowers you with guidance and support to understand your options and create a path forward.

If you’re only looking for a general list of resources, you can contact 211 for a full directory of services.
- Full Name*
  
  First NameLast Name
- Contact Number to Reach You *
  Please enter a valid phone number.Format: (000) 000-0000.
- Email Address*
  example@example.com
- I am looking for a general list of resources (housing, food, services)I need help navigating resources or figuring out next stepsI’m not sure what I need
- For comprehensive resource lists for housing, food, and community services, please contact 211, which provides the most up-to-date resource directory in Southern Nevada. https://www.nevada211.org/
  - Phone Call 2-1-1 or 1-866-535-5654
  - Text Zip Code to 898211
  - Chat with Nevada 211
- Virtual AppointmentIn-Person Appointment
- In-person Appointment*
- Virtual Appointment*
- CounselingCrisis+HoldsDisabilityDomestic ViolenceEmploymentEmotional SupportFood/NecessitiesGreif/BereavementHousingIncarcerationJustice System InvolvementLegal AssistanceLGBTQIA+Medical CareMental Health Assessment/Getting a DiagnosisMental Health Facilities QuestionsMental Health Rights Violations/GrievancesNAMI Programs/EventsOrganizational PartnershipPrescription AssistancePsychiatrySchool/EducationSelf Help/Coping SkillsSenior Population (55+)Sexual AssaultSpanish Speaking ResourcesSSI/Government BenefitsSubstance AbuseSuicide Support/PreventionSupport GroupsTrainingsTransportationVeteran/Active DutyYouth (14-24yrs)
- Additional Information:
- YesNo
- Email For Newsletter
  example@example.com
- Nombre Completo*
  
  First NameLast Name
- Número de teléfono para contactarle*
  Please enter a valid phone number.Format: (000) 000-0000.
- Correo electrónico*
  example@example.com
- Llamada telefónicaCorreo electrónicoCita presencial
- Cita en persona
- Cita telefónica
- ConsejeríaRetenciones por crisisDiscapacidadViolencia domésticaEmpleoApoyo emocionalAlimentos y necesidades esencialesDueloRecursos de viviendaEncarcelamientoRecursos del sistema judicialAsistencia legalLGBTQIA+Atención médicaEvaluación de salud mental/Obtención de un diagnósticoPreguntas sobre centros de salud mentalViolaciones de los derechos en salud mental/ReclamacionesProgramas/Eventos de NAMIAsociación organizacionalAsistencia para obtener medicamentos a bajo costoPsiquiatríaRecursos escolares o educativosHerramientas de autoayuda y habilidades para enfrentar desafíosAdultos mayores (55+)Agresión sexualRecursos en españolBeneficios del Seguro Social/Beneficios gubernamentalesAbuso de sustanciasApoyo/Prevención del suicidioGrupos de apoyoEntrenamientosTransporteVeterano/Servicio activoAdolescentes y jóvenes (14-24 años)
- Por favor, incluya cualquier información adicional que desee que el operador sepa:
- SíNo
- 988/Servicios de CrisisAmigo/a o ser queridoBoca a bocaSitio webRedes socialesOther
- SíNo
- What is your zip code?*
- What is your sexual orientation?
- What is your gender identity ?
- What is your age (in years)?*
- American Indian or Alaska NativeAsian or Pacific IslanderAsianNative Hawaiian or other Pacific IslanderBlack or African AmericanWhiteHispanicTwo or more racesSome Other Race Alone
- Hispanic OriginPuerto RicanMexicanCubanOther Specific HispanicNot of Hispanic OriginPrefer not to answer
- Full TimePart TimeUnemployedHomemakerStudentRetiredDisabledPrefer not to answer
- Never MarriedMarried/ Living as a CoupleSeparatedDivorcedWidowedPrefer not to answer
- HomelessFoster Home/ Foster CareResidential CareCrisis ResidenceInstitutional settingJail/ Correctional FacilityPrivate ResidenceIndependent Living (Able to manage daily living activities without regular support)Dependent Living (Receives regular help with daily living activities from a caregiver, family member, or staff)Prefer not to answer
- YesNo
- YesNo
- If you don’t have Medicaid, do you have other insurance? If yes, please list your provider.*
- What challenges, if any, do you face accessing physical and mental health care?
- Are you currently in school?
- Hearing or severe hearing impairment (such as deafness)Seeing or severe vision impairment (such as blindness)Remembering, concentrating, or making decisionsWalking, climbing stairs, using your hands, reaching, lifting, or carryingDressing, bathing, or getting around inside the homeGoing outside the home alone (e.h., to shop or go to the doctor's)Finding, keeping, or having a jobNone of the abovePrefer not to answerNot Applicable
- Please Indicate your highest level of education.
- Highest Level of Education/School Grade
- Estimated Yearly Income or Income Range.
- YesNo
- YesNo
- 988/Crisis ServicesFriend/loved oneWord of mouthWebsiteSocial mediaOther
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CARES (Resource Navigation)Request