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Mental Health Association

Contact Form

Not sure which Services you would like to pursue? Please fill out this form and someone will contact you as soon as possible.

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of person or agency that sent you to us (if applicable):

Phone # of person or agency that sent you to us (if applicable):

What brings you to the Mental Health Association?

Please indicate if you are interested in any of the following:

Help with resource connections (ie. SNAP, housing, DHS, etc.)

Help understanding and managing employment related benefits while working

Help with finding and maintaining employment

Help with building skills for daily living

Help with your child or children (under 18) who have mental health or behavioral issues

Help with other family members

Meet with a group of people with the same issues or experiences for support

Explore mental wellness through creative arts

Evening hours peer support for your mental health recovery

If you would like to provide any additional information you feel may help determine which of our services would benefit you the most, please add it here:

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