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AIFS Family Assistance Intake Questionnaire
Thank you for reaching out to the AIFS (Assistance and Intervention for Families Services). Your well-being is our priority, and we are here to offer support tailored to your unique needs. Please complete the following questionnaire to help us understand your situation better.
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* Indicates required question
Email
*
Your email
First Name and last Name
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Number of Household Members
Your answer
Country of Origin
Your answer
Briefly describe your current situation
Your answer
What specific type of assistance are you seeking? (Select all that apply)
*
Financial Assistance
Housing Support
Food and Nutrition Assistance
Educational Support
Counseling or Mental Health Services
Employment assessment
Legal Aid
Healthcare Access
Translation/ Interpretation
Childcare
Transportation
Public benefits Application
Driving Education
Community Inclusion
Clothes
Other:
Required
Signature
*
Your answer
Your answer
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