CARES Resource Navigation Request (Andre)

Evaluation Language Preference

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
- What kind of support are you looking for?
- 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
- Appointment Type
- In-person Appointment
- Virtual Appointment
- Primary Needs and Concerns
- Additional Information:
- Would you like to receive more information from NAMI?
- 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
- ¿Cómo le gustaría ser contactado?
- Cita en persona
- Cita telefónica
- Necesidades y preocupaciones principales
- Por favor, incluya cualquier información adicional que desee que el operador sepa:
- ¿Está cubierto por Medicaid/Medicare?
- ¿Cómo se enteró de nosotros?
  
  Other
- ¿Le gustaría recibir más información de NAMI?
- What is your zip code?
- What is your sexual orientation?
- What is your gender identity ?
- What is your age (in years)?
- What is your race?
- What is your ethnicity?
- What is your current employment status?
- What is your current marital status?
- What is your current residential status?
- Are you covered under medicaid/medicare?
- Are you a veteran?
- 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?
- Do physical, mental, or emotional challenges cause you difficulty with: (Choose as many as you like)
- Please Indicate your highest level of education.
- Highest Level of Education/School Grade
- Estimated Yearly Income or Income Range.
- Do you have any challenge with substance abuse?
- Are you currently involved in, or have you previously been involved in, the criminal justice system (e.g., probation, parole, court involvement, incarceration)?
- How did you hear about us?
  
  Other
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CARES (Resource Navigation)Request