Social Care Network Screening

Fill Out the Self-Screening Form.

Answer questions about food, housing, transportation, employment, education, and safety.

Social Care Network Screening

Self-Screening Form

Answer clear questions about food, housing, transportation, employment, education, and safety.

Question 0We use this survey to understand needs our members have which could interfere with good health. We may share your answers with your other health care providers, and with your health plan and social services organizations, so they can determine if you qualify for any free non-medical services that could be helpful. Please check this box if you agree to continue. You can choose not to answer this survey, but we can only check for services if you do answer.