Survivor Needs Assessment

Please take just a moment and fill out this confidential needs assessment and email directly to us by clicking the "Submit" button located at the bottom of this page. By doing this we will be better equipped to service your needs.

Full Name:
Street Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Method of Contact:	-- Select One -- Phone E-mail U.S. Mail
Please select the following services you are in need of:
SOS Financial Counseling: Provides assistance and education in investments, insurance, debt management, checking and savings, estate planning, mortgages, garnishments, foreclosures and credit repair.
SOS Support Coordination: Provides supportive counseling, life skills education, and coordinates free counseling services from agencies such as Military Family Life Consultants, VA Grief and Bereavement Counseling, Military OneSource, Army Family Life Chaplains, Social Work Services, Army Substance Abuse Program, and other community agencies.
U.S. Army Benefits: Death Gratuity, Survivor Benefit Plan, DEERS, TRICARE and Legal Assistance (SJA).
VA Benefits: Dependency and Indemnity Compensation, Servicemen’s Group Life Insurance, Veterans Group Life Insurance, National Servicemen Life Insurance, VA Home Loan, Improved Pension for Non-Service Connected Death, Burial Expense and Education benefits.
Long Term Family Case Management: Provides assistance in obtaining Service Records and Reports (such as awards, citations, CID, LOD, etc.)
Child and Youth Programming: Counseling, free respite care, lower childcare rates, SKIESUnlimited instructional classes, New Parent Support Program, School Liaison Services, playgroups, grief camps and other surviving child activities.
Army Community Service: Army Volunteer Corp, Army Emergency Relief, Family Advocacy, Relocation Readiness, Employment Readiness, Army Family Team Building and the Army Family Action Plan.
Airmen and Family Readiness or Fleet Family Support Center Programs: The Air Force and Navy equivalents of Army Community Service for Survivors living outside the immediate Fort Benning/Columbus, GA area.
Enter the four-digit code displayed then click "Submit" below.