Site Menu

Case Management

Client Intake Form for Case Management - Part One

In order to know how to best assist you, we need some basic information about you, your background, and your present circumstances. Our Case Managers will review your information and respond back to you.

Application Notes:

  • Nothing in this application shall be construed as a contract or guarantee. Information is used to determine applicant fitness for assistance, mentoring, emergency shelter admission, or temporary housing program.
  • Information shall be handled as confidentially as possible with GUUM Team Members and used to make decisions concerning applicant in regard to participation in assistance and volunteering.
  • Any information applicant provides that is false, incomplete or deceptive by what is reported or not reported is grounds to terminate assistance without notice. Applicant affirms all information is true.