HI Laura,

 

     We use an online form in person appointment or online - https://ccchouston.org/ceap/

 

      It is our LIHEAP registration form, but it is also our intake form as well for any in-person appointments for other  benefits.

 

Emily

 

From: bec@lists.ncoa.org <bec@lists.ncoa.org> On Behalf Of Laura Ramos
Sent: Monday, February 22, 2021 9:13 AM
To: bec@lists.ncoa.org; erin.kee@ncoa.org
Cc: Sonya Barrera-Medrano <SBarrera-Medrano@aacog.com>
Subject: RE: [EXTERNAL] BEC Listserv: Request - Client Intake Form

 

Ms. Kee,

 

Attached is our BEC flyer, per your request.

Please let us know if you need anything else.

 

Thank you,

 

 

Laura Ramos

Medicare Benefits Counselor

Alamo Area Council of Governments

2700 NE Loop 410, Ste. 101

San Antonio, Tx  78217

Office:  210/362-5271

Mobile:  210/381-8963

Fax: 1-866-332-3252

Email:  lramos@aacog.com

 

 

 

 

From: Sonya Barrera-Medrano
Sent: Monday, February 22, 2021 8:59 AM
To: Laura Ramos <LRamos@aacog.com>
Subject: RE: [EXTERNAL] BEC Listserv: Request - Client Intake Form

 

Erin below, please cc me..

 

Sonya Barrera-Medrano

Benefits Counseling Coordinator

Area Agencies on Aging

Alamo Area Council of Governments

2700 NE Loop 410, Suite 101

San Antonio, TX 78217

210-918-1281 - Office

210-389-8723 – AACOG Cell

SBarrera-Medrano@aacog.com

 

 

 

 

 

 

From: bec@lists.ncoa.org [mailto:bec@lists.ncoa.org] On Behalf Of Erin Kee
Sent: Monday, February 22, 2021 8:27 AM
To: bec@lists.ncoa.org
Subject: [EXTERNAL] BEC Listserv: Request - Client Intake Form

 

Good morning,

 

We are looking to update our resource library with an example of a client intake form you use for BEC clients when they first visit your organization. If you have an example you’d like to share, could you please send to me today?

 

Best,

 

Erin

 

Erin Kee McGovern, J.D., MELP

Director of Programs, Center for Benefits Access

Phone: 571-527-3940

erin.kee@ncoa.org   

 

National Council on Aging

Improving the lives of millions of older adults, especially those who are struggling

251 18th Street South, Suite 500

Arlington, VA 22202

www.ncoa.org |@NCOAging

 

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