Assistance Request – Thrive Community Health Network

Thrive Community Health Network has a team of enrollment navigators available to help you find health insurance, apply for food assistance, obtain prescription eyeglasses, and/or apply for help with your utility bills. If you would like to request assistance, please submit the form below, and someone will reach out to you within the next 2 business days.

First Name*

Last Name*

Phone*

Email*

What area do you live in?*

Please specify:

What language do you speak?*

What type of assistance do you need?* (ctrl+click to select multiple)

Please follow this link to fill out the Skippy Consent form:
Skippy Consent Form

Please follow this link to fill out the Teletherapy Intake form:
Teletherapy Intake Form

Please follow this link to fill out the Good Neighbor Fund application:
Good Neighbor Fund Application

If you have any questions, please email enrollment@tchnetwork.org or give us a call at 970.708.7096