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Screening Form

September 21, 2018

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 fax it to 361-561-8610 or email to Program Coordinator, Isabel Gonzales at or Case Managers Elizabeth DeLeon, 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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