Intake Form

Veteran Intake Form

Please take the time and fill out as much information as possible, for things you wish not to disclose or don't understand, please leave blankThis information will be used to further assist Wisconsin Veterans Network in providing you assistance. All information will be secured and only shared with supporting agencies. If you have any questions, please feel free to call at 414-257-3624. Once complete, your VetsNet navigator will asses the information, and give you a call.