Assistance Request Form

By completing the form below, you’ll be entered into our secure, coordinated network of community resources, powered by Unite Us, that is available to help. A Unite Us Care Coordination team member will contact you within 2 business days. This form is not intended for emergent needs. For medical emergencies, please call 911 immediately.

Other Important Hotlines:

• 988 – Suicide & Crisis Lifeline
• 844-671-1019 – NJ DMAVA Veterans Services Hotline