May 31, 2026

Intake & Document Room 

Heaven-Sent Client Intake Form
HEAVEN SENT COMMUNITY SERVICE AND VETERANS ASSISTANCE
We need to help… We just HAVE to help!
It’s in our souls. Be the LIGHT that helps others see

Household and Contact Information

Needs and Veteran Status

ID Verification (staff use)

☐ Driver license provided
☐ Photo ID provided
☐ VA card provided
☐ ID verified by video or staff review
Applicant signature / date:

Where Your Intake Form Goes Next

This intake form is the first step, not the whole story. After we collect this information, our team moves your case into the rooms and programs below so we can walk with you from crisis to stability.

Heaven-Sent Veterans Assistance Contacts

If you need to reach someone directly while you are filling out this form, you can contact any member of our leadership team using the phone numbers and emails below.

Joe Ryan
Founder, Executive Director & Intake Lead
Tim
Disaster Relief & Housing Navigation
Darrell
VA Coaching & Benefits Navigation
Teresa
Director of Faith & Pastoral Care