Community & Family Connections Referral Form
The Jeffco Schools Medicaid program and the Homeless Service program have merged together. We continue to assist families living in transition (homeless) as well as assist families applying for Medicaid/CHP+ and provided resources for other medical concerns. With this merge we have divided the articulation areas (High Schools and the schools that feed into them) between the 4 team members. You will see our contact information below in the CFC Liaison selection.
Name of Person Submitting Referral
if not staying with legal parent or guardian (unaccompanied youth) please type N/A.
Parent/Guardian Contact/Phone Number
If you do not have a phone number, please type N/A.
Referral's Contact/Phone Number
Language Spoken at Home
Jeffco Schools CFC Liaison
Oscar Fonseca-303-982-0830 (Jefferson Articulation Area and Option schools)
Amy McDaniel - 303-982-2096 (Conifer, Evergreen, Green Mountain, Lakewood, and Pomona Articulation Areas)
Laura Monreal - 303-982-0831 (Standley Lake, Ralston Valley, Arvada, and Arvada West Articulation Areas)
Beatriz Monsalve- 303-982-6618 (Alameda and Golden Articulation Areas)
Yvette Martinez - 303-982-3215 (Bear Creek, Chatfield, Columbine, Dakota Ridge and Wheat Ridge Articulation Areas)
House/Apt/Condo/Townhome/Duplex (Owned or Rented)
Living with relatives/friends due to financial hardship
Substandard Housing/ Abandoned Building/ Public place/train or bus station
Living in campground/RV/car
Other (describe in Notes field below)
Medical/Medicaid/CHP+ Need Only
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