38VFR.org Intake Form
Our goal in creating this form is to help connect you with services, information, and/or support as efficiently as possible.

Please, if you are experiencing suicidal thoughts or thoughts of harming someone else call 911 or check into the nearest emergency room.

National Suicide Prevention Hotline 1-800-273-8255


Informed Consent:

3/8 Veterans of Fallujah and Ramadi is a 501(c)(3) nonprofit dedicated to serving veterans of 3rd Battalion 8th Marines, their families, and the Gold Star Families of our fallen brothers. We also strive to serve all combat veterans through direct support or by referral to an appropriate organization that can provide assistance.

This form is intended to help us understand and connect you to the services you need. We are a referral resource and make every effort to connect you with the appropriate services. We are not health or mental health-care professionals.

Full Name
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Phone Number
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Address
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Email
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Branch of Service
MOS/Job Title
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Combat Deployment (s)
Theater of Combat Deployment(s)
Reason for Assistance
By entering your name and clicking submit below you understand and agree that we will use the information in this form to help connect you with the requested services and that you may be contacted by these services.
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