COVID Intake Form

egskynet's picture
Submitted by egskynet on Mon, 03/26/2018 - 10:44pm
*CONSUMER ELIGIBILITY

To be eligible for Northern Nevada Center for Independent Living COVID-19 services, a person must have been affected by COVID-19 and/or the resulting economic shutdown. In order to document that you are eligible for these services, please answer the following:

CONSUMER INFORMATION