Supportive Services for Veterans Families Program

The goal of the SSVF Program is to promote housing stability among very low-income Veteran
families who reside in or are transitioning to permanent housing.

Each Veteran will receive services including but not limited to:

Outreach Services
Case Management Services
Assistance in Obtaining VA Benefits
Assistance in Obtaining and Coordinating Other Public Benefits Available
Temporary Financial Assistance

Supportive Services for Veterans Families Referral

"*" indicates required fields

The Veteran listed below is in need of the following service:*

Rapid Re-Housing

Homeless Prevention

Please attach eligibility documentation if available, i.e. proof of income, DD214, homeless verification, etc.

Drop files here or

Max. file size: 50 MB.

Applicants may indicate interest and start the prescreening process by filling out this form

Name*

First Last

Date*

Address*

Street Address Address Line 2 City State ZIP / Postal Code

County

Phone*

Email*

I hereby authorize the reciprocal release of information between Lutheran Social Services and the following agency/representative

Referral Source/Agency

Name/Title

Phone

Client Signature*

Date*

*This consent expires one year from the date it was signed or if the client withdraws the consent.

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Supportive Services for Veterans Families Program

Supportive Services for Veterans Families Referral

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