Virtual Intake

Let’s start with your safety

Every intake begins with a safety check, whether you’re reaching out for yourself, a family member, or on behalf of an agency. From there, we follow the same five-step process for every case.

If you are in immediate danger

Call 911, or reach the Veterans Crisis Line at 988, then press 1.

You can also text 838255 or chat at veteranscrisisline.net. Please still finish the form below so we can follow up.

Immediate Safety Review

Are you — or the client you’re referring — currently facing an immediate threat to life, health, or safe shelter?

Yes No

Full Name

Contact Email or Phone Whichever is easiest for us to reach you at.

I Am Contacting As

Service Requested

Anything We Should Know? (optional)

I consent to be contacted about the services described above.

Submitting this form does not create a client relationship. Someone from Network32 will follow up to begin the five-step intake process.

Email

drperrywright@network32ag.com

Phone

Direct phone line coming soon — use the form above for the fastest response.