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Get Help from IAVA’s Rapid Response Referral Program

Get Help from IAVA's Rapid Response Referral Program

Thank you for reaching out to IAVA’s Rapid Response Referral Program (RRRP). Below are our intake questions which will help us determine how we can best assist you.


If you are currently experiencing a crisis please call the Veterans Crisis Line at 1.800.273.8255, and press 1. If you need immediate medical attention, please call 911 or go to your nearest emergency room.

Please accept our terms before completing our intake form.

Why are you reaching out to RRRP?


Demographic Information












Military Information

Veteran - Service Details







Please write "Infantry" instead of 11B/0311, etc.





Your connection with the Department of Veteran Affairs












If you are a veteran family member reaching out on behalf of yourself and/or your family, please complete the following section with your veteran family member's information to the best of your ability.








Please write "Infantry" instead of 11B/0311, etc.





Tell us about the veteran's connection with the Department of Veteran Affairs












Home, family and employment










What is the total amount of earned income for your household. This includes your spouse and working dependents.
Physical & Mental Health Needs