The AEOA Community Resource Hub makes it easier for pregnant individuals and families with young children (birth-8 years old) to get what they need by increasing access to services. Our Hub Navigators work with pregnant individuals and families with young children to provide one-on-one assistance and help navigating and applying for services, as well as sharing online tools and providing support to help families thrive.

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* 1. Please provide demographic information.

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* 2. County/Tribal Nation

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* 3. Family Type

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* 4. Total number of children in household

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* 5. Number of children in each age group? If zero, leave blank.

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* 6. Race

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* 7. Ethnicity

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* 8. How did you hear about AEOA's Community Hub?

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* 9. What services are you looking for? Please check all that apply.

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* 10. What barriers were keeping you from accessing services?

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* 11. Anything else you'd like to share?

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* 12. Preferred method of contact

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* 13. Preferred time of day to contact

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