Interest Form

United for Waukesha Resiliency Center, a program of NAMI Southeast WI, provides no-cost programs and service coordination to anyone affected by the Waukesha Christmas Parade tragedy. Our Service Navigators assist you in finding the right treatment options and ensure it is provided at no-cost to you or your family through our grant funding. Please complete and interest form if you would like to receive more information.

Interest Form

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Next Steps: Sync an Email Add-On

To get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.
Your Name(Required)
Your Email Address(Required)
What services are you interested in discussing? Choose all that apply.(Required)
How did you hear of our services?(Required)

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