Please note that the Student and Family Outreach Program operates on a limited basis between June 13 and July 24. Please leave a voicemail at 720-972-6015 and someone will return your call within 48 hours. You may also send us an email using the Contact Tab.

Please complete this form if you, your family, or someone else:

• Needs help applying for health insurance (Health First Colorado (formerly Medicaid) / CHP+)
• Needs access to community resources (food, clothing, counseling, etc.)
• Needs Homeless Assistance (please note that under the McKinney-Vento Act, students in any of the following situations may qualify for homeless assistance: students who are living "doubled up" with family or friends due to economic hardship; students who are living in inadequate housing that lacks proper utilities or electricity, windows or walls, or has an insect or rodent infestation; students who are living in homeless shelters; students who are living in parks or cars; students who are completely unsheltered)
• Is a youth not living with their parent or legal guardian, involuntarily, due to economic hardship or family conflict
• Is involved with the child welfare system, including foster care and kinship placement

Only one referral needs to be submitted per household.

NOTE: If you are referring someone else, please make sure that they have provided consent prior to completing and submitting this form