Veterans Services Pre-Screening Form

If you would like to be screened for Veterans Services eligibility, including the Supportive Services for Veteran Families (SSVF) grant, or would like additional information about resources for veterans, please complete the form below.  Your responses will be sent to a Veteran Services outreach specialist, who will contact you within three business days.

To qualify for Veterans Services support, you or someone in your household must have served in the U.S. Military.

List the source of income and the gross amount from any of the following: earned income, pension, retirement, unemployment, disability, SSI/SSD, TANF, alimony, child support, armed forces income, interest and dividend income, G.I. Bill housing stipend.