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Get Help Now

If you're ready to take the next step towards stable housing and supportive services, we're here to guide you. Please complete the form below, providing us with details about your current situation and the assistance you require. Our team is committed to responding promptly and connecting you with the resources you need to build a secure and healthier future.

 

Let's work together to find the support you deserve.

Start Here!

Fill out the form and submit below.

Are you currently:
OK to contact
Yes
No
Birthday
Month
Day
Year
What Health Plan Do You Have?
Kaiser
CalOptima
Other
Are you enrolled in Medi-Cal?
Yes
No

Please share any additional information that will help us get you the support you need (do you need housing support, medical support, or both?)

Release of Information: I hereby authorize Housing for Health to use my information connected with these services, including but not limited to, insurance carriers, health networks, hospital workers, agencies and anyone assisting in obtaining coverage.

I Consent
Yes
No
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