1.Housing

I have a place to live today but I am concerned about where I will live in the future.

I do not have a steady place to live.

I am living in an unsafe housing situation.

Other (please specify)

None of the above

2.Utilities

I currently have utility services but I am concerned about keeping them connected.

I do not have access to some utilities.

Other (please specify)

None of the above

3.Food

I frequently worry about having enough money to buy groceries.

I do not have the ability to shop for food.

I am frequently not sure where my next meal will come from.

I need food tonight.

Other (please specify)

None of the above

4.Clothing

I need clothing that will allow me to dress appropriately for work or an interview.

My clothing is in need of replacement due to wear and tear but I do not have money to replace it.

I currently do not have appropriate clothing to wear and I have immediate clothing needs.

Other (please specify)

None of the above

5.Transportation

I have transportation today for daily living but I am concerned about being without transportation in the near future.

I currently do not have a reliable form of transportation to get to work, church, grocery store or healthcare appointments.

I require special accommodations for travel and do not have access to appropriate transportation that meets my needs.

Other (please specify)

None of the above

6.Physical Health

I need direction as to which type of professional I need to contact to address my specific physical health issues.

I need assistance in finding free or low-cost health clinics and resources.

I am interested in information about preventative health care resources.

I am interested in finding an accountability partner or group to join in order to encourage me to improve my physical health.

Other (please specify)

None of the above

7.Mental Health: (NOTE: If you are in immediate need of mental health resources, please call 988.)

I am looking for free or low-cost mental health counseling resources.

I am looking for spiritual counseling.

I am interested in a support group with others who are experiencing the same issues that I am.

Other (please specify)

None of the above

8.Career and Education

I need assistance with a resume or Curriculum Vitae.

I am looking for free or low-cost tutoring resources.

I am interested in talking with someone through a career or educational degree change.

Other (please specify)

None of the above