Please help us identify community needs!

At OC United, we’re always looking at ways that we can fine-tune our programs and offerings, but more than that, we want to make sure that we are hearing from our families the ways in which we can tangibly and supportively walk with them in their caregiving journeys.

Please take a few moments to help us make sure that we have the best contact information for you and that we get an opportunity to hear about where we might be able to help meet your needs.

If you have any questions, please feel free to contact Stacie, Resource and Adoptive Family Support Advocate, at [email protected] or Renae, the Director of Trauma and Whole-Person Care, at [email protected].

We look forward to hearing from you!

  • Is this your first assessment? Then select "Initial Intake." If you have filled this out before but have a new need, please select "Emergent Need." If you are providing us with new information after receiving a notice, please select "Annual Follow-up."
  • Which descriptions best fit your caregiving role (select all that apply)?
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    Which descriptions best fit your caregiving role (select all that apply)
  • If "Other" was selected above
  • Please enter N/A if there are no children currently in care. Click on the (+) plus sign to add additional lines each child
    NameAgeGenderFoster (F), Adopted (A), Kinship (K), or Biological (B) 
  • This field is hidden when viewing the form
    Please note if Foster (F), Adopted (A), Kinship (K), or Biological (B)
  • (years, months)
  • (FFA, county, etc.)

  • Interview Questions

    Please fill out these questions so we can best support you through our program
  • What are the best ways that you have been supported in your journey either by agencies or groups? (i.e., various trainings, childcare services, meals, etc.):
  • How have we helped you? (if applicable)
  • Mark all that apply. If "other" is selected, please make note.
  • This field is hidden when viewing the form
    Mark all that apply. If "other" is selected, please make note.
  • If you selected "other," please make note here
  • Please mark all that apply. If you select "Other," please add note in the space below.
  • This field is hidden when viewing the form
    Please mark all that apply. If you select "Other," please add note in the space below.
  • If you selected "Other" above, please add note here.
  • Some of our higher-level services (i.e., Care Communities, Parent Coaching, Therapy Linkage etc.) require the creation of an Individual or Family Support plan. Are you interested in meeting with a Support Advocate to create that plan?
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  • www.facebook.com/groups/TraumaWise.OCUnited
  • This field is hidden when viewing the form
    www.facebook.com/groups/RESPITE.OCUnited

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