SecondChanceAct.org — Get Help Intake

Get Help — Intake Form

Use this form to request reentry support, housing navigation, benefits help, or legal resource referrals.

Privacy note: This demo form downloads your submission as a JSON file when hosted as a static site. To enable real submissions, set window.SCA_CONFIG.intake_endpoint in assets/js/config.js.

Full Name

Phone

State

Primary Need

Are you currently experiencing homelessness?

Brief description

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