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Screening Form

October 19, 2021

Please open the below PDF file and complete the screening form and submit to HOPES II. Our staff will review the screening and we will contact you for future services. 

Print screening form  and email to Program Coordinator, Sabrina Juarez;

Case Managers: Jennifer Jackson, Phil De La Garza, Patricia Trevino

We recommend using Google Chrome if you want to fill out this form online.

Click here to fill out form.


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