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NAMI Clackamas Resource/Peer Support Referral
Complete ths form to refer an individual or yourself.
Services provided at NO COST!
Contact NAMI Clackamas at 503-344-5050 or info@namicc.org
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Today's Date
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Name
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Phone Number
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Email Address
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Do they/you live in Clackamas County?
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What information or resources are they/you seeking?
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Housing
Public Transportation
Employment
Public Benefits (such as SNAP, food, clothing, and more)
Locating a psychiatrist, doctor, or other healthcare professional
Legal
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This form was created inside of National Alliance on Mental Illness of Clackamas County.
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