Service Inquiry
This form is intended for those seeking services with our agency.
If this is a crisis situation or you need immediate assistance, please call or text our 24/7 Crisis Line: 940-382-7273.
First Name
Last Name
Safe Phone Number to Leave a Voicemail
Safe E-mail
City of Residence
Primary Language
Which Services Do You Need? (Select all that apply)
Counseling
Child/Adolescent Counseling
Legal Services
Emergency Shelter
Housing Assistance
Food Resources
Career Resources
Safety Planning
Comments
Contact Information