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Benefits Navigation

CBS Benefits Navigation Questionnaire

  1. Contact Information
  1. Household Information
Marital Status
Gender
Housing Situation
Do you have a disability?
  1. What Do You Need Help With?
Please select all that apply
  1. Additional Information
  1. Preferred Contact Method
How would you like CBS staff to contact you?
  1. Consent to Contact
I agree to be contacted by CBS regarding my request for assistance.
I agree

Submitting this form does not guaranteed eligibility for benefits or services. CBS provides information, screening, referrals, and application/enrollment assistance. Official eligibility decisions are made by program agencies.

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Let's See What You May Qualify For

Not sure where to start? To help you find out, answer a few questions about your household, income, and needs. This usually takes about 2 minutes.

Note: This questionnaire is for screening/navigation only; it does not replace an official eligibility determination for benefits.

Have Questions?

We're here to help. Reach out to our team of experts and we'll make sure you get the information and support you need.

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