Community Partners

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Annual Membership Fee
(valid 10/1/2023–9/30/2024)

A member of our team will reach out to you for payment and placement.
Annual Membership Fee:

2024 Year Membership ($25.00)Request Financial Aid

Youth first name:
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Youth Birthday:

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This consent covers all information shared by you or by anyone that has the right to share information on your behalf and is relevant to the recipient's involvement in your care or payment for your care. You can always limit the information you provide on the Network by requesting to have it removed.

To understand how your information may be used and kept safe on the Network, please see uniteus.com/privacy.

If you no longer want your information shared on the Network, you can email consent@uniteus.com or ask any Network partner.
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