DEV - MLP Screener

Your healthcare team wants to help you live the healthiest life possible. Problems in your home, school, or work can sometimes affect your health.  Your team at [location] may have information or resources that can help you address these types of issues. Please read the disclaimer below before beginning.

During the past month, have you or anyone in your household experienced any of the following issues? Click on the issue that applies to you or your family from the list below.

  1. The food in our household has run out before we could buy more.
  2. Someone in my household has not come to see their doctor here at [location] or filled prescriptions from [location] because of costs. (medical costs)
  3. Conditions in my home are unsafe or unhealthy. (habitability)
  4. I am in danger of losing my home or car. (eviction/foreclosure/repossession)
  5. Debt collectors are contacting me about overdue accounts. (debt collection)
  6. I recently lost my job or cannot find a job due to my health problems or a family member’s disability. (disability/FMLA)
  7. I have lost my job or cannot find a job due to my criminal history. (expungement)
  8. Someone in my household has been the victim of abuse or domestic violence. (domestic abuse)
  9. A child in my household has problems in school due to a medical condition or learning disorder. (special education)
  10. I need help with public benefits or a government agency. (for example, DHS: SNAP, Medicaid, TEA; Social Security Administration: SSI, SSDI (disability); public housing authorities or Section 8 vouchers; IRS). (public benefits)
  11. I have been served with court papers and am not currently represented by an attorney. (Advise to call Helpline and/or go directly to ALSP website)
  12. I have other civil legal issues (not criminal) and want more information on legal services. (Go directly to ALSP website)