Benefits Finder Questions


1 .

2 .




3 .




3 a.
(If applicable)



3 b. In addition to your current marital status, have you previously been:
(Check all that apply)





4 .




5 .




6 . What best describes your health situation?
(Check all that apply)











7 . Do you have children?
(Check all that apply)







7 a. What are the ages of your dependent children?
(Check all that apply)









7 b. What are your children's health situations?
(Check all that apply)










8 .




8 a.



8 b.



9 .




9 a. In terms of housing, you are interested in:
(Check all that apply)







10 . Are any members of your immediate family recently deceased?
(Check all that apply)








10 a.



11 . I am...
(Check all that apply)


















The Benefits Finder does not require or collect any personal information (see Important Notices).